MEDICARE: KURT W RATHJEN MD PA

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	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician
2	207X00000X	Orthopaedic Surgery Physician

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
2	0025HW	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1902811862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KURT W RATHJEN MD PA

Provider Business Mailing Address
First Line	:	PO BOX 660046
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75266-0046
Country	:	US
Telephone Number	:	214-369-8555
Fax Number	:	214-369-2683

Provider Business Practice Location Address
First Line	:	411 N WASHINGTON AVE
Second Line	:	SUITE 7500
City	:	DALLAS
State	:	TX
Zip	:	75246-1713
Country	:	US
Telephone Number	:	214-824-4866
Fax Number	:

Authorized Official
Title or Position	:	BILLING DIRECTOR
Name	:	SHEILA FOUNTIAN
Credential	:
Telephone Number	:	214-369-8555

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	05/15/2008

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Directions to “KURT W RATHJEN MD PA ” Practice Location

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