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WAYNE L BAKOTIC D.O.

Dermatopathology >> Pathology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1295798320

Individual Registrant:
 WAYNE L BAKOTIC D.O.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
114 MIMOSA DR SUITE C THOMASVILLE, GA 31792-6677 US
Tel: 229-228-6496  Fax: 229-228-6510

Contact information for business:
PO BOX 2717  THOMASVILLE, GA 31799-2717 US
Tel: 229-228-6496  Fax: 229-228-6510

Registration Information:
NPI: 1295798320
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207ZD0900XAllopathic & Osteopathic Physicians
Pathology
Dermatopathology
GA051017

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
075954118AGA05




HEALTH CARE JOBS GA - Page 1



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