1801927108 NPI number — KURT W ROHREN MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801927108 NPI number — KURT W ROHREN MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

ROHREN

Provider First Name:

KURT

Provider Middle Name:

W

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1801927108

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/07/2015

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 394

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

GRETNA

Provider Business Mailing Address State Name:

NE

Provider Business Mailing Address Postal Code:

68028-0394

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

877-406-2916

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

1010 THREE SPRINGS BLVD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

DURANGO

Provider Business Practice Location Address State Name:

CO

Provider Business Practice Location Address Postal Code:

81301-8296

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

970-764-2286

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

03/08/2007

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0202X , with the licence number:  31457 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: RAB6508 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
• Identifier: T0845 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
• Identifier: 01314574 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
• Identifier: 66551 . This is a "PRESBYTERIAN HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 841155936001 . This is a "ROCKY MOUNTAIN HEALTH" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
• Identifier: 8378317 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
• Identifier: 114630100 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
• Identifier: 84115593602 . This is a "PACIFICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: W4726 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
• Identifier: XPY191623 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: 194994 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
• Identifier: MD457CO , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
• Identifier: P8B114117 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".