Provider Demographics
NPI:1811952617
Name:HALES, KURT A (MD)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:A
Last Name:HALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:435-688-4843
Mailing Address - Fax:435-688-4835
Practice Address - Street 1:544 S 300 E
Practice Address - Street 2:MATERNAL FETAL MEDICINE
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770
Practice Address - Country:US
Practice Address - Phone:435-688-4843
Practice Address - Fax:435-688-4835
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT104387207VM0101X
UT8250635-1205207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8304N3Medicare ID - Type Unspecified
F75511Medicare UPIN
TX129207007Medicaid