Provider Demographics
NPI:1356397731
Name:KMC MEDICAL MARKETING
Entity type:Organization
Organization Name:KMC MEDICAL MARKETING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TUCKER
Authorized Official - Middle Name:ULIT
Authorized Official - Last Name:TUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-736-2185
Mailing Address - Street 1:3212 BELGRAVE FALLS LANE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-2995
Mailing Address - Country:US
Mailing Address - Phone:512-736-2185
Mailing Address - Fax:512-282-7099
Practice Address - Street 1:3212 BELGRAVE FALLS LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-2995
Practice Address - Country:US
Practice Address - Phone:512-736-2185
Practice Address - Fax:512-282-7099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies