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Organization
MBK GASTRO LLC
Active
Organization
MBK GASTRO LLC
Active
Parent organization
MBK GASTRO LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MBK GASTRO LLC
Authorized official
MARK B KUKLER DO (MANAGING PHYSICIAN)
(770) 883-1176
Entity
Organization
Contact information
Practice address
763 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 883-1176
(678) 985-1999
Mailing address
763 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 883-1176
(678) 985-1999
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
NULL
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
01/27/2021
Last updated
03/29/2021
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