Individual
MR. CASEY JORDAN KUKIELSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-1544
(434) 924-2283
(434) 982-0019
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101278438
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116037519
VA
Other
Enumeration date
03/20/2019
Last updated
09/19/2023
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