Healthcare Provider Details

I. General information

NPI: 1871583187
Provider Name (Legal Business Name): JOHN PETER KUGLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 FARRELL RD
FORT BELVOIR VA
22060-5901
US

IV. Provider business mailing address

93 ENGLAND RUN LN
FREDERICKSBURG VA
22406-1069
US

V. Phone/Fax

Practice location:
  • Phone: 703-805-0303
  • Fax: 703-681-1242
Mailing address:
  • Phone: 540-371-8363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number0101051094
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberG38256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: