Healthcare Provider Details

I. General information

NPI: 1770548810
Provider Name (Legal Business Name): KURT V VOELLMICKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 POST RD W
WESTPORT CT
06889-3412
US

IV. Provider business mailing address

PO BOX 29234
NEW YORK NY
10087-9234
US

V. Phone/Fax

Practice location:
  • Phone: 203-291-2275
  • Fax: 203-391-2277
Mailing address:
  • Phone: 203-391-2275
  • Fax: 203-391-2277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number40208
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number208465
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number208465
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: