Kucker, Mark Allen

Kucker, Mark Allen is an sole proprietor health care provider with primary practice located at 161 N Causeway Ste D , New Smyrna Beach FL 32169-5300. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kucker, Mark Allen can be contacted via phone (386) 428-6660.

Contact Information

Primary practice address
161 N Causeway Ste D New Smyrna Beach FL 32169-5300
Phone: (386) 428-6660
Fax: (386) 428-6696
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS5998 Florida

Profile Details

NPI number 1447360367
LBN Legal business name Kucker, Mark Allen
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447360367 NPPES
Florida Other 010589572 TAX ID#
Florida Other OS5998 TAX ID#
Florida Other 80725 TAX ID#

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