Provider Demographics
NPI:1467474247
Name:KINSEY GOTIER, KRISTI NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:NICOLE
Last Name:KINSEY GOTIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:NICOLE
Other - Last Name:KINSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8225 MALL PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-6994
Mailing Address - Country:US
Mailing Address - Phone:770-981-2100
Mailing Address - Fax:770-808-8445
Practice Address - Street 1:8225 MALL PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-6994
Practice Address - Country:US
Practice Address - Phone:770-981-2100
Practice Address - Fax:770-808-8445
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD026744207R00000X
GA061108207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine