Healthcare Provider Details

I. General information

NPI: 1215912811
Provider Name (Legal Business Name): KURT DENNIS RUHT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10290 N 92ND ST SUITE 205
SCOTTSDALE AZ
85258-4522
US

IV. Provider business mailing address

10290 N 92ND ST SUITE 205
SCOTTSDALE AZ
85258-4522
US

V. Phone/Fax

Practice location:
  • Phone: 480-451-4117
  • Fax: 480-451-8726
Mailing address:
  • Phone: 480-451-4117
  • Fax: 480-451-8726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number11342
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: