Individual
JOHN J KUDLAK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
200 PATEWOOD DR, SUITE B300, GREENVILLE, SC 29615-3593
(864) 454-4200
(864) 454-4205
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
714
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007147
—
SC
01
—
P00265774
RR MEDICARE
SC
01
—
P00801525
RAILROAD MEDICARE
SC
Enumeration date
05/25/2006
Last updated
12/15/2025
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