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NPI Code Detail

MEDICARE: DR. KAITLYN MARIE HURST M.D.

MEDICARE: DR. KAITLYN MARIE HURST M.D.
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
1207X00000XOrthopaedic Surgery Physician0101271603VA
2207XX0004XOrthopaedic Foot and Ankle Surgery Physician0101271603VA
3207X00000XOrthopaedic Surgery Physician2022-00463NC

General Provider Information

NPI Number : 1518317668
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAITLYN MARIE HURST M.D.
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12611 N COMMUNITY HOUSE RD STE 100
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-3817
Country : US
Telephone Number : 704-316-3410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2016
Last Update Date : 09/16/2022

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