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NPI Code Detail

MEDICARE: KURT O DOGGWILER M.D., PH.D.

MEDICARE: KURT O DOGGWILER M.D., PH.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
12085R0202XDiagnostic Radiology Physician9000NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P000606388OTHERNVRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942206933
Entity Type Code : Individual
Provider Name (Legal Business Name) : KURT O DOGGWILER M.D., PH.D.
Provider Business Mailing Address
First Line : PO BOX 21609
Second Line :
City : CARSON CITY
State : NV
Zip : 89721-1609
Country : US
Telephone Number : 775-884-2455
Fax Number : 775-884-0345
Provider Business Practice Location Address
First Line : 1310 24TH AVE S # 114
Second Line :
City : NASHVILLE
State : TN
Zip : 37212-2637
Country : US
Telephone Number : 615-873-7765
Fax Number : 615-873-8321
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 10/15/2018

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