Organization
MBK GASTRO LLC
Active
Parent organization
MBK GASTRO LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MBK GASTRO LLC
Authorized official
MARK B KUKLER DO (MANAGING PHYSICIAN)
(770) 883-1176
Entity
Organization
Contact information
Practice address
763 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 883-1176
(678) 985-1999
Mailing address
763 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 883-1176
(678) 985-1999
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
01/27/2021
Last updated
03/29/2021
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