Healthcare Provider Details

I. General information

NPI: 1629309778
Provider Name (Legal Business Name): JOSEPH A KOT PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 EMERY HWY
MACON GA
31217-3692
US

IV. Provider business mailing address

175 EMERY HWY
MACON GA
31217-3692
US

V. Phone/Fax

Practice location:
  • Phone: 478-751-4446
  • Fax: 478-751-4530
Mailing address:
  • Phone: 478-751-4446
  • Fax: 478-751-4530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: