Slavko Kukucka M.D.
Urgent Care Clinic/Center in Rincon, GA(View on Map)
Full Name
Slavko Kukucka M.D.
NPI Number
1568437507
NPI Type
Individual Provider
Gender
Male
Enumeration Date
02/22/2006
Specialties
(Taxonomies)Code
261QU0200X
207Q00000X
Primary Taxonomy
Yes
No
Licenses
State
Georgia
License Number
046877
Contact
Information
Purpose
Mailing
Location
Address
119 CHIMNEY RD
119 CHIMNEY RD
City
Rincon
Rincon
State
GA
GA
Postal Code
31326
31326
Country
US
US
Telephone Number
(912) 826-0229
(912) 826-0229
Identifiers
Identifier
52782040-008
000843235F
52782040-009
GRP2837
P00441748
582203199-009
CG4057
G46877
582203199-004
Identifier State
GA
GA
GA
GA
GA
GA
GA
SC
GA
Identifier Issuer
BCBS GA FOR SAVANNAH LOCATION
Unknown
BCBS/GA FOR POOLER LOCATION
MEDICARE GROUP ID
RR MEDICARE
TRICARE ID
RR MEDICARE GROUP ID
Unknown
TRICARE ID
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/14/2024