Provider Demographics
NPI:1508893280
Name:LOTNER, GARY Z (MD)
Entity Type:Individual
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First Name:GARY
Middle Name:Z
Last Name:LOTNER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:114 TOWNPARK DR NW
Mailing Address - Street 2:SUITE 240
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-3715
Mailing Address - Country:US
Mailing Address - Phone:770-952-8612
Mailing Address - Fax:678-803-6944
Practice Address - Street 1:2296 HENDERSON MILL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345
Practice Address - Country:US
Practice Address - Phone:770-491-9300
Practice Address - Fax:770-496-4955
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-08-11
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Provider Licenses
StateLicense IDTaxonomies
GA020572207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00210075GMedicaid
D30094Medicare UPIN
GA00210075GMedicaid