Healthcare Provider Details

I. General information

NPI: 1306826268
Provider Name (Legal Business Name): KURT L HANSBERRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 08/29/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 17TH AVE E
ALEXANDRIA MN
56308-5273
US

IV. Provider business mailing address

610 30TH AVE WEST ALEXANDRIA CLINIC
ALEXANDRIA MN
56308
US

V. Phone/Fax

Practice location:
  • Phone: 320-763-2707
  • Fax: 320-762-6117
Mailing address:
  • Phone: 320-763-5123
  • Fax: 320-763-7883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number38699
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: