Organization
JOHN COTTAM MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNA FRAME (BILLING MANAGER)
(423) 525-5993
Entity
Organization
Contact information
Practice address
304 N MAIN ST, CHIEFLAND, FL 32626-0803
(813) 962-4210
(813) 962-0566
Mailing address
14310 N DALE MABRY HWY STE 180, TAMPA, FL 33618-2059
(813) 962-4210
(813) 962-0566
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000831900
—
FL
Enumeration date
09/15/2022
Last updated
09/15/2022
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