Provider Demographics
NPI:1235193251
Name:KOTZ, KRISTI L (DO)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:L
Last Name:KOTZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7790 EASTON RD
Mailing Address - Street 2:
Mailing Address - City:OTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18942-1765
Mailing Address - Country:US
Mailing Address - Phone:610-847-2071
Mailing Address - Fax:610-847-2006
Practice Address - Street 1:8330 EASTON RD STE C
Practice Address - Street 2:
Practice Address - City:OTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18942-1615
Practice Address - Country:US
Practice Address - Phone:267-424-8020
Practice Address - Fax:866-326-8660
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS008852L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA005502Medicare PIN
PAG63438Medicare UPIN