Healthcare Provider Details

I. General information

NPI: 1023133246
Provider Name (Legal Business Name): THOMAS L KURT MD MPH MASTERS IN PU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 RIVERSIDE DRIVE
ASPEN CO
81612
US

IV. Provider business mailing address

PO BOX 7977 1375 RIVERSIDE DRIVE
ASPEN CO
81612
US

V. Phone/Fax

Practice location:
  • Phone: 970-925-6648
  • Fax: 970-925-9432
Mailing address:
  • Phone: 970-925-6648
  • Fax: 970-925-9432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083T0002X
TaxonomyMedical Toxicology (Preventive Medicine) Physician
License Number15157
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: