Provider Demographics
NPI:1255439436
Name:KUGLER, MORRIS A (MD)
Entity type:Individual
Prefix:DR
First Name:MORRIS
Middle Name:A
Last Name:KUGLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2227 VADALABENE DR
Mailing Address - Street 2:STE 300
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-5823
Mailing Address - Country:US
Mailing Address - Phone:618-288-7485
Mailing Address - Fax:618-288-9086
Practice Address - Street 1:2227 VADALABENE DR
Practice Address - Street 2:STE 300
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-5823
Practice Address - Country:US
Practice Address - Phone:618-288-7485
Practice Address - Fax:618-288-9086
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2009-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036041568208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036041568Medicaid
IL036041568Medicaid
C37989Medicare UPIN