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General NPI Number Information
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NPI Number | 1689870479
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Entity Type | Individual
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Provider Name | GEORGE H KOTTI III M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 12/13/2009
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Provider Practice Location Address
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Address Line | 301 FISHER ST STE 1F-130
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City | KEESLER AFB
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State | MS
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Zip | 39534-2508
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Country | US
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Telephone | 228-376-3812
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Fax |
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Provider Business Mailing Address
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Address Line | 5809 OLDE OAKVIEW
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-8733
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Country | US
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Telephone | 228-327-5160
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 233262
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License Number State | NE
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