MEDICARE: MARC W KUNDLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	P6441	TX
2	2084P0800X	Psychiatry Physician	25390	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51516662	OTHER	AL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265488928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC W KUNDLER MD

Provider Business Mailing Address
First Line	:	2868 ACTON RD
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35243-2502
Country	:	US
Telephone Number	:	205-968-8360
Fax Number	:	205-968-8373

Provider Business Practice Location Address
First Line	:	1515 S CAPITAL OF TEXAS HWY STE 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-6544
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	01/13/2026

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