Kukuck, Todd G

Kukuck, Todd G is an individual health care provider with primary practice located at 3101 Breckenridge Ln Suite 1A, Louisville KY 40220-2742. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Kukuck, Todd G can be contacted via phone (502) 458-7400.

Contact Information

Primary practice address
3101 Breckenridge Ln Suite 1A Louisville KY 40220-2742
Fax: (502) 458-7449
Website:

Health care specialties

Profile Details

NPI number 1558358762
LBN Legal business name Kukuck, Todd G
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2005
Last updated Jun 17th, 2010 - about 12 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 1558358762 NPPES
Kentucky Other 1075148 PASSPORT
Kentucky Other 430009072 PASSPORT
Kentucky MEDICAID 74383951 PASSPORT
Kentucky Other 2435210000 PASSPORT
Kentucky Other 000000283592 PASSPORT

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