Provider Demographics
NPI:1750386496
Name:KUGLER, GARY (DPM)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:KUGLER
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:224D CORNWALL ST NW
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19440 GOLF VISTA PLAZA, SUITE 120
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8272
Practice Address - Country:US
Practice Address - Phone:703-858-7887
Practice Address - Fax:703-858-7453
Is Sole Proprietor?:No
Enumeration Date:2005-06-18
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000893213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1750386496Medicaid
VA178243YAHKMedicare PIN
VA4940330001Medicare NSC
VAU51425Medicare UPIN