Healthcare Provider Details

I. General information

NPI: 1235898271
Provider Name (Legal Business Name): JOSEPH M. KUKLA DPM, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3047 CENTER POINT RD NE STE A
CEDAR RAPIDS IA
52402-4064
US

IV. Provider business mailing address

3047 CENTER POINT RD NE STE A
CEDAR RAPIDS IA
52402-4064
US

V. Phone/Fax

Practice location:
  • Phone: 319-365-6973
  • Fax: 319-365-6974
Mailing address:
  • Phone: 319-365-6973
  • Fax: 319-365-6974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH M KUKLA
Title or Position: OWNER
Credential: DPM
Phone: 319-365-6973