# KIRIT K KOTHARI MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164542957
- **Authorized official:** DR. KIRIT K KOTHARI MD (MD PRESIDENT KIRIT K KOTHARI MD PC)
- **Authorized official phone:** (570) 992-1234

## Contact information

- **Practice address:** ROUTE 115 & SWITZGABLE ROAD, BRODHEADSVILLE, PA 18322
- **Practice address phone:** (570) 992-1234
- **Practice address fax:** (570) 992-8610
- **Mailing address:** PO BOX 637, BRODHEADSVILLE, PA 18322
- **Mailing address phone:** (570) 992-1234
- **Mailing address fax:** (570) 992-8610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | MD058095L | PA | Yes |

## Other

- **Enumeration date:** 03/29/2007
- **Last updated:** 07/07/2008