Organization
RASTISLAV KUCINSKY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RASTISLAV KUCINSKY MD (OWNER)
(541) 884-6233
Entity
Organization
Contact information
Practice address
2614 CLOVER ST, KLAMATH FALLS, OR 97601-1132
(541) 884-6233
Mailing address
PO BOX 5109, KLAMATH FALLS, OR 97601-0119
(541) 882-1540
(541) 882-2583
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD28454
OR
207RI0011X
Interventional Cardiology Physician
Primary
MD28454
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026194
—
OR
01
—
P00641241
RAILROAD MEDICARE
OR
Enumeration date
09/21/2011
Last updated
11/22/2011
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