Provider Demographics
NPI:1932370467
Name:H.J. KURTZMAN DPM & ASSOCIATES LLC
Entity Type:Organization
Organization Name:H.J. KURTZMAN DPM & ASSOCIATES LLC
Other - Org Name:HENRY J KURTZMAN SOLE MBR
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:H
Authorized Official - Middle Name:J
Authorized Official - Last Name:KURTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:419-756-9111
Mailing Address - Street 1:1069 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-2265
Mailing Address - Country:US
Mailing Address - Phone:419-756-9111
Mailing Address - Fax:410-756-0191
Practice Address - Street 1:1069 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-2265
Practice Address - Country:US
Practice Address - Phone:419-756-9111
Practice Address - Fax:410-756-0191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36001677K213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2510232Medicaid
OH6618790001Medicare NSC
H037660Medicare PIN
OH2510232Medicaid