| Doctor Name: | KURT JOSEPH GUSTAFSON |
| NPI Number: | 1326069055 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | SC004598L |
| Business Practice Address: | 215 S 1st St Lehighton, PA - 182352163 |
| Business Phone Number: | 6103775544 |
| Business Fax Number: | 6103776744 |
| Mailing Address: | 215 S 1st St, LEHIGHTON |
| State: | PA |
| Postal Code: | 182352163 |
| Phone Number: | 6103775544 |
| Fax Number: | 6103776744 |
| NPI Enumeration Date: | 07/21/2006 |
| NPI Last Update Date: | 06/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | SC004598L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |