MEDICARE: KYLE EVAN CURTIS MD

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	207L00000X	Anesthesiology Physician	30745	NE
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207L00000X	Anesthesiology Physician	MD25583	ME

General Provider Information

NPI Number	:	1780047639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE EVAN CURTIS MD

Provider Business Mailing Address
First Line	:	5418 WOODVIEW DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-1427
Country	:	US
Telephone Number	:	207-949-1184
Fax Number	:

Provider Business Practice Location Address
First Line	:	2817 REILLY ST
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0004
Country	:	US
Telephone Number	:	910-907-6000
Fax Number	:

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

Provider Enumeration Date	:	03/29/2016
Last Update Date	:	05/01/2022

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