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General NPI Number Information
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NPI Number | 1184824757
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Entity Type | Individual
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Provider Name | KEVIN D KURT O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 01/20/2021
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Provider Practice Location Address
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Address Line | 2418 CROSSROADS DR STE 1900
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City | MADISON
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State | WI
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Zip | 53718-7997
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Country | US
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Telephone | 608-245-4020
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Fax | 608-245-4028
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Provider Business Mailing Address
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Address Line | 2418 CROSSROADS DR STE 1900
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City | MADISON
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State | WI
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Zip | 53718-7997
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Country | US
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Telephone | 608-245-4020
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Fax | 608-245-4028
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046010002
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License Number State | IL
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