Provider Demographics
NPI:1538189055
Name:GOLD, KURT V (MD)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:V
Last Name:GOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7919 WAKELEY PLAZA
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114
Mailing Address - Country:US
Mailing Address - Phone:402-933-2016
Mailing Address - Fax:402-393-8384
Practice Address - Street 1:7919 WAKELEY PLAZA
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114
Practice Address - Country:US
Practice Address - Phone:402-933-2016
Practice Address - Fax:402-393-8369
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19463208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1158105Medicaid
NE280119463Medicaid
NE280119463Medicaid
F87908Medicare UPIN
NE273621GOMedicare ID - Type Unspecified