Provider Demographics
NPI:1275590879
Name:KOKOLSKI, GEORGE M JR (DO)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:M
Last Name:KOKOLSKI
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1879 RIVER OAKS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-7640
Mailing Address - Country:US
Mailing Address - Phone:757-272-7977
Mailing Address - Fax:757-920-5652
Practice Address - Street 1:1879 RIVER OAKS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-7640
Practice Address - Country:US
Practice Address - Phone:757-272-7977
Practice Address - Fax:757-920-5652
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102049935207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00087330OtherRAILROAD
VA010025451Medicaid
VAP00087330OtherRAILROAD
VA010025451Medicaid
VA004767R22Medicare PIN