| Ajay M Kothari Md Llc | |
|
136 S Lee St Ste A Americus GA 31709-3698 | |
| (229) 380-0266 | |
| (229) 380-0267 |
| Full Name | Ajay M Kothari Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 136 S Lee St Ste A, Americus, Georgia |
| Authorized Official Name and Position | Ajay Maheshchandra Kothari (PHYSICIAN) |
| Authorized Official Contact | 2299429534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ajay M Kothari Md Llc 109 Morningside Drive Americus GA 31709 Ph: (229) 942-9534 | Ajay M Kothari Md Llc 136 S Lee St Ste A Americus GA 31709-3698 Ph: (229) 380-0266 |
| NPI Number | 1831445634 |
|---|---|
| Provider Enumeration Date | 07/30/2012 |
| Last Update Date | 10/15/2024 |
| Certification Date | 10/15/2024 |
| Medicare PECOS PAC ID | 1850549148 |
|---|---|
| Medicare Enrollment ID | O20120911000549 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831445634 | NPI | - | NPPES |
| 00075963G | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 26984 (Georgia) | Primary |
| Provider Name | Ajay Maheshchandra Kothari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568473551 PECOS PAC ID: 9638170996 Enrollment ID: I20070130000007 |
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