Provider Demographics
NPI:1831208743
Name:KOCHERLA, AMY J (MD)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:J
Last Name:KOCHERLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 NUNNALLY WAY
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-5318
Mailing Address - Country:US
Mailing Address - Phone:229-438-5448
Mailing Address - Fax:
Practice Address - Street 1:17432 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:GA
Practice Address - Zip Code:39813
Practice Address - Country:US
Practice Address - Phone:229-725-3135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058359207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine