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General NPI Number Information
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NPI Number | 1245344753
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Entity Type | Individual
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Provider Name | DOUGLASS RAYMOND KURTZ PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 605 N WESTOVER BLVD
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City | ALBANY
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State | GA
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Zip | 31707-2188
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Country | US
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Telephone | 229-434-4200
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Fax | 229-434-1488
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Provider Business Mailing Address
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Address Line | 801 13TH AVE STE A
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City | ALBANY
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State | GA
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Zip | 31701-1345
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Country | US
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Telephone | 229-436-6688
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Fax | 229-436-0307
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 003832
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 003832
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License Number State | GA
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