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. |
|---|
| 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 |