MEDICARE: JENIFER KURTZ MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	MD0000031607	TN
2	315D00000X	Inpatient Hospice	MD0000031607	TN
3	313M00000X	Nursing Facility/Intermediate Care Facility	MD0000031607	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336148816
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENIFER KURTZ MD PC

Provider Business Mailing Address
First Line	:	PO BOX 391
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37901-0391
Country	:	US
Telephone Number	:	865-573-4794
Fax Number	:	865-573-4794

Provider Business Practice Location Address
First Line	:	3608 BLUFF POINT DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37920-2806
Country	:	US
Telephone Number	:	865-573-4794
Fax Number	:	865-573-4794

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. CHARLES THOMAS ALCORN
Credential	:
Telephone Number	:	865-573-4794

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	01/09/2015

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