Healthcare Provider Details

I. General information

NPI: 1376520056
Provider Name (Legal Business Name): BRADLEY DAVID KURTZ D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2373 CENTRAL PARK BLVD UNIT 202
DENVER CO
80238-2300
US

IV. Provider business mailing address

5657 S HIMALAYA ST SUITE100
CENTENNIAL CO
80015-5307
US

V. Phone/Fax

Practice location:
  • Phone: 303-699-6200
  • Fax: 720-974-9811
Mailing address:
  • Phone: 303-699-6200
  • Fax: 720-870-0242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number42432
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: