Healthcare Provider Details

I. General information

NPI: 1992706857
Provider Name (Legal Business Name): KURT T KUBICKA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 W 6TH AVE SUITE 511
HELENA MT
59601-5036
US

IV. Provider business mailing address

PO BOX 1130
HELENA MT
59624-1130
US

V. Phone/Fax

Practice location:
  • Phone: 406-443-2101
  • Fax: 406-422-0807
Mailing address:
  • Phone: 406-443-3076
  • Fax: 406-449-6531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License NumberMED-PHYS-LIS-7430
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7430
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMED-PHYS-LIS-7430
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number7430
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: