Provider Demographics
NPI:1245299791
Name:MARTIN KULIG MD
Entity type:Organization
Organization Name:MARTIN KULIG MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:KULIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:325-947-6440
Mailing Address - Street 1:2502 SOUTHLAND BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904
Mailing Address - Country:US
Mailing Address - Phone:325-947-6440
Mailing Address - Fax:325-947-6289
Practice Address - Street 1:3501 KNICKERBOCKER ROAD
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904
Practice Address - Country:US
Practice Address - Phone:325-947-6440
Practice Address - Fax:325-947-6289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty