Provider Demographics
NPI:1992706857
Name:KUBICKA, KURT T (MD)
Entity type:Individual
Prefix:MR
First Name:KURT
Middle Name:T
Last Name:KUBICKA
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:PO BOX 1130
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-1130
Mailing Address - Country:US
Mailing Address - Phone:406-443-3076
Mailing Address - Fax:406-449-6531
Practice Address - Street 1:7 W 6TH AVE
Practice Address - Street 2:SUITE 511
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5036
Practice Address - Country:US
Practice Address - Phone:406-443-2101
Practice Address - Fax:406-422-0807
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PHYS-LIS-7430207QS1201X, 207Q00000X
MT7430207Q00000X, 207QS1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F75627Medicare UPIN