MEDICARE: DR. LAZAROS K KOCHILAS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0202X	Pediatric Cardiology Physician	MD11036	RI
2	2080P0202X	Pediatric Cardiology Physician	216383	MA
3	2080P0202X	Pediatric Cardiology Physician	073331	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548232036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAZAROS K KOCHILAS M.D.

Provider Business Mailing Address
First Line	:	2835 BRANDYWINE RD
Second Line	:	SUITE 300
City	:	ATLANTA
State	:	GA
Zip	:	30341-5510
Country	:	US
Telephone Number	:	404-256-2593
Fax Number	:	770-488-9408

Provider Business Practice Location Address
First Line	:	5461 MERIDIAN MARK RD STE 530
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-3283
Country	:	US
Telephone Number	:	404-256-2593
Fax Number	:	770-488-9408

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	03/24/2023

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Directions to “ DR. LAZAROS K KOCHILAS M.D.” Practice Location

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