Provider Demographics
NPI:1871559930
Name:VERNON, KURT GERARD (MD)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:GERARD
Last Name:VERNON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3412 BIRK BLUFF CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-8224
Mailing Address - Country:US
Mailing Address - Phone:910-891-5808
Mailing Address - Fax:910-891-5323
Practice Address - Street 1:904 W BROAD ST STE D
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-4147
Practice Address - Country:US
Practice Address - Phone:910-891-5808
Practice Address - Fax:910-891-5323
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9501139207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC85016OtherBLUE CROSS BLUE SHIELD NC
NC8985016Medicaid
NC84580OtherMEDCOST
NC8985016Medicaid
NC84580OtherMEDCOST