Provider Demographics
NPI:1871570697
Name:KUKLA, ROBERT FRANCIS (DPM)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:FRANCIS
Last Name:KUKLA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1501 TATE BLVD SE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4243
Mailing Address - Country:US
Mailing Address - Phone:828-304-0400
Mailing Address - Fax:828-304-0142
Practice Address - Street 1:1501 TATE BLVD SE
Practice Address - Street 2:SUITE 203
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4243
Practice Address - Country:US
Practice Address - Phone:828-304-0400
Practice Address - Fax:828-304-0142
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC169213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00059478OtherRAILROAD MEDICARE
NC8908111Medicaid
NC5009660004Medicare NSC
NC8908111Medicaid
NC243094CMedicare PIN