Healthcare Provider Details

I. General information

NPI: 1811952617
Provider Name (Legal Business Name): KURT A HALES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

544 S 300 E MATERNAL FETAL MEDICINE
SAINT GEORGE UT
84770
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 435-688-4843
  • Fax: 435-688-4835
Mailing address:
  • Phone: 435-688-4843
  • Fax: 435-688-4835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number104387
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number8250635-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: