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General NPI Number Information
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NPI Number | 1255439436
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Entity Type | Individual
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Provider Name | MORRIS A KUGLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 02/10/2009
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Provider Practice Location Address
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Address Line | 2227 VADALABENE DR STE 300
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City | MARYVILLE
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State | IL
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Zip | 62062-5823
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Country | US
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Telephone | 618-288-7485
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Fax | 618-288-9086
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Provider Business Mailing Address
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Address Line | 2227 VADALABENE DR STE 300
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City | MARYVILLE
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State | IL
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Zip | 62062-5823
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Country | US
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Telephone | 618-288-7485
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Fax | 618-288-9086
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036041568
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License Number State | IL
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