Basic Information
| Provider Information | |||||||||
| NPI: | 1376585059 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POSSAI | ||||||||
| FirstName: | KURT | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3001 SANFORD PKWY | ||||||||
| Address2: | |||||||||
| City: | THIEF RIVER FALLS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 567012700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2186832725 | ||||||||
| FaxNumber: | 2186832725 | ||||||||
| Practice Location | |||||||||
| Address1: | 3001 SANFORD PKWY | ||||||||
| Address2: | |||||||||
| City: | THIEF RIVER FALLS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 567012700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2186814747 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2006 | ||||||||
| LastUpdateDate: | 12/01/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 43229 | MN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0900330 | 01 | MN | MEDICA # | OTHER | 142048 | 01 | MN | UCARE # | OTHER | 19484 | 01 | MN | NDBS # | OTHER | 92D03PO | 01 | MN | MNBS # | OTHER | 98D09PO | 01 | FM | MNBS # | OTHER | 1154017 | 01 | MN | AMERICA'S PPO/ARAZ # | OTHER | 11858 | 05 | MN | MEDICAID | MN200034 | 01 | MN | LHS/BANNERHEALTH # | OTHER | 0900335 | 01 | MN | MEDICA # | OTHER | 901452700 | 05 | MN | MEDICAID | DA9021026992 | 01 | MN | PREFERRED ONE # | OTHER | DA9071026992 | 01 | MN | PREFERRED ONE # | OTHER | HP38401 | 01 | MN | HEALTHPARTNERS # | OTHER |