Individual
DR. FRED CHARLES KOBYLARZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 EAST HOSPITAL ROAD, FORT GORDON, GA 30905-5650
(706) 787-1145
Mailing address
300 EAST HOSPITAL ROAD, FORT GORDON, GA 30905-5650
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89765
GEORGIA COMPOSITE MEDICAL BOARD
GA
Enumeration date
05/27/2020
Last updated
08/14/2021
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