Individual
MARK B. KUKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
763 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(678) 985-2000
(678) 985-1999
Mailing address
763 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(678) 985-2000
(678) 985-1999
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036800
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00540185B
—
GA
01
—
309492
WELLCARE
GA
Enumeration date
05/11/2006
Last updated
06/29/2010
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