MEDICARE: DR. BRADLEY DAVID KURTZ D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	42432	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376520056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY DAVID KURTZ D.O.

Provider Business Mailing Address
First Line	:	5657 S HIMALAYA ST
Second Line	:	SUITE100
City	:	CENTENNIAL
State	:	CO
Zip	:	80015-5307
Country	:	US
Telephone Number	:	303-699-6200
Fax Number	:	720-870-0242

Provider Business Practice Location Address
First Line	:	2373 CENTRAL PARK BLVD UNIT 202
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80238-2300
Country	:	US
Telephone Number	:	303-699-6200
Fax Number	:	720-974-9811

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	07/21/2022

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