MEDICARE: DR. KURT GLAESSER M.D.

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	2085R0202X	Diagnostic Radiology Physician	29637	AZ

General Provider Information

NPI Number	:	1518166628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KURT GLAESSER M.D.

Provider Business Mailing Address
First Line	:	6890 E SUNRISE DR # 120-220
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750-0738
Country	:	US
Telephone Number	:	520-298-1138
Fax Number	:

Provider Business Practice Location Address
First Line	:	6270 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5831
Country	:	US
Telephone Number	:	520-298-1138
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	07/18/2007

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