Individual
RICHARD KUCKELMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 CARONDELET DR, KANSAS CITY, MO 64114-4673
(913) 599-6777
(913) 599-3955
Mailing address
9212 NIEMAN RD, OVERLAND PARK, KS 66214-1868
(913) 599-6777
(913) 599-3955
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
105558
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100159050B
—
KS
05
—
206973901
—
MO
01
—
20876021
BCBS PROVIDER NUMBER
—
Enumeration date
06/04/2006
Last updated
07/08/2007
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