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Individual

MARK W KUNKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
195
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000078227
BLUE CROSS
AL
05
000078227
AL
05
009931924
AL
01
051528924
BLUE CROSS
AL
Enumeration date
06/29/2006
Last updated
06/14/2011
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