Provider Demographics
NPI:1821041880
Name:KOCSIS, PAUL MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MARK
Last Name:KOCSIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:284 EXECUTIVE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1833
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:5841 US 421 S
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-6713
Practice Address - Country:US
Practice Address - Phone:910-893-5727
Practice Address - Fax:910-893-6404
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2022-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC94008812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC137WGOtherBCBS
NC89137WGMedicaid
NC89137WGMedicaid