Healthcare Provider Details

I. General information

NPI: 1215048988
Provider Name (Legal Business Name): JAMES HOTZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 WALNUT AVE S
LEESBURG GA
31763-4367
US

IV. Provider business mailing address

204 N WESTOVER BLVD
ALBANY GA
31707-2983
US

V. Phone/Fax

Practice location:
  • Phone: 229-759-6508
  • Fax: 229-759-9950
Mailing address:
  • Phone: 229-888-6559
  • Fax: 229-436-4107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number018908
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: