| Mbk Gastro Llc | |
|
763 Old Norcross Rd Lawrenceville GA 30046-4317 | |
| (770) 883-1176 | |
| (678) 985-1999 |
| Full Name | Mbk Gastro Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 763 Old Norcross Rd, Lawrenceville, Georgia |
| Authorized Official Name and Position | Mark B Kukler (MANAGING PHYSICIAN) |
| Authorized Official Contact | 7708831176 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mbk Gastro Llc 763 Old Norcross Rd Lawrenceville GA 30046-4317 Ph: (770) 883-1176 | Mbk Gastro Llc 763 Old Norcross Rd Lawrenceville GA 30046-4317 Ph: (770) 883-1176 |
| NPI Number | 1912598699 |
|---|---|
| Provider Enumeration Date | 01/27/2021 |
| Last Update Date | 03/29/2021 |
| Medicare PECOS PAC ID | 3678972809 |
|---|---|
| Medicare Enrollment ID | O20210520001262 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912598699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Scott W Schorr |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275583437 PECOS PAC ID: 1658443296 Enrollment ID: I20101020000721 |
| Provider Name | Mark B Kukler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093765265 PECOS PAC ID: 6002988649 Enrollment ID: I20101027000231 |
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