Healthcare Provider Details

I. General information

NPI: 1871570697
Provider Name (Legal Business Name): ROBERT FRANCIS KUKLA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 TATE BLVD SE SUITE 203
HICKORY NC
28602-4243
US

IV. Provider business mailing address

1501 TATE BLVD SE SUITE 203
HICKORY NC
28602-4243
US

V. Phone/Fax

Practice location:
  • Phone: 828-304-0400
  • Fax: 828-304-0142
Mailing address:
  • Phone: 828-304-0400
  • Fax: 828-304-0142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number169
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: