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NPI Code Detail

MEDICARE: MR. KURT HAROLD PULVER PA

MEDICARE: MR. KURT HAROLD PULVER PA
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
1363A00000XPhysician Assistant61TN

General Provider Information

NPI Number : 1558367045
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KURT HAROLD PULVER PA
Provider Business Mailing Address
First Line : 1724 HAMILL RD STE 204
Second Line :
City : HIXSON
State : TN
Zip : 37343-5098
Country : US
Telephone Number : 423-877-4705
Fax Number :
Provider Business Practice Location Address
First Line : 1724 HAMILL RD STE 204
Second Line :
City : HIXSON
State : TN
Zip : 37343-5098
Country : US
Telephone Number : 423-877-4705
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 02/22/2024

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Directions to “ MR. KURT HAROLD PULVER PA” Practice Location

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