Healthcare Provider Details

I. General information

NPI: 1952530222
Provider Name (Legal Business Name): ROBERT LLOYD LOTT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 OSLER CT
ALBANY GA
31707
US

IV. Provider business mailing address

PO BOX 13834
TALLAHASSEE FL
32317-3834
US

V. Phone/Fax

Practice location:
  • Phone: 229-518-2700
  • Fax: 850-402-9130
Mailing address:
  • Phone: 850-205-6230
  • Fax: 850-402-9130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME143144
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number070200
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: