Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 2005007061 | MO |
Y | 207T00000X | Neurosurgeon | Q8094 | TX |
NPI | 1023081254 |
---|---|
Provider Name | Dr. Scott Kutz |
First Address | Plano, TX 75024-4334 |
Second Address | Plano, TX 75024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 14/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023081254 | (05) | MO |
1516369 | (05) | TN |
H18616 | (02) | MO |
P00254599 | RAILROAD MEDICARE (01) | MO |
P00653954 | RAILROAD MEDICARE -SJC (01) |