Search › Washington › 208G00000X
John Kuckelman
NPI 1669882304 · on the registry since 2014
Practice
- Address
- 9040 Jackson Ave
Joint Base Lewis Mcchord, WA 98431 - Phone
- (253) 968-1110
- Clinicians at this address
- 47
Additional practice sites
- 1120 15th St, Augusta, GA
- 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA
Registry record
- Primary taxonomy
- 208G00000X
208G00000X
- Also registered as
- 208G00000X
390200000X - Licence states on file
- GA, WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-05-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington