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General NPI Number Information
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NPI Number | 1003179961
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Entity Type | Individual
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Provider Name | GREGORY SCOTT KOTTKAMP M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 11/28/2025
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Provider Practice Location Address
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Address Line | 180 FLOYD AVE
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City | ROCKY MOUNT
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State | VA
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Zip | 24151-1318
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Country | US
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Telephone | 540-489-6353
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Fax |
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Provider Business Mailing Address
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Address Line | 213 S JEFFERSON ST STE 1006
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City | ROANOKE
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State | VA
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Zip | 24011-1713
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101287682
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | LL34900
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 49242
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License Number State | KY
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