Everything you always wanted to know about DR. KOTHEIMER CONRAD GREGORY M.D. but were afraid to ask.
Provider Prefix | Provider Last Name | Provider Middle Name | Provider First Name | Provider Credential | DR. | KOTHEIMER | CONRAD | GREGORY | M.D. |
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identifier | description | issuer | state |
---|---|---|---|
Taxonomy | State | License Number | Primary? |
---|---|---|---|
207R00000X Internal Medicine | MP | 0410 | Y |
Type | Number |
---|---|
Practice Location Address Fax Number | 6702368600 |
Mailing Address Telephone Number | 9035957349 |
Practice Location Address Telephone Number | 6702852626 |
Mailing Address Fax Number | 9035931966 |
Type | Address | City | State | Postal | Country |
---|---|---|---|---|---|
Mailing Address | 3728 SOUTHPARK DR | TYLER | TX | 75703 | TX |
Practice Location Address | 1 LOWER NAVY HILL | GARAPAN | SAIPAN | 0 | SAIPAN |