Male or Other

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

Provider Address