Organization Name: | KURTIS A. WATERS, M.D., P.A. |
NPI Number: | 1265583652 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KURTIS ALLEN WATERS (DIRECTOR) |
Mailing Address: | 13359 Isle Dr Suite 1 Baxter |
State: | MN US |
Postal Code: | 564252221 |
Phone Number: | 2184548888 |
Fax Number: | |
NPI Enumeration Date: | 01/15/2007 |
NPI Last Update Date: | 01/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207YS0123X |
License Number: | 37843 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Otolaryngology |
Taxonomy Specialization: | Facial Plastic Surgery |
Taxonomy Definition: | An otolaryngologist who specializes in facial plastic surgery. |