ALEXANDER G BOUTSELIS (NPI# 1831167147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831167147 |
| Entity Type | Individual |
| Full Name | ALEXANDER G BOUTSELIS |
| Credential | MD |
| Practice Address |
913 Pleasant Ridge Ct Lafayette IN 47904-2784 |
| Mailing Address |
Po Box 4699 Lafayette IN 47903-4699 |
| Practice Telephone | 7654263164 |
| Mailing Telephone | 7654477447 |
| Mailing Fax Number | 7658070553 |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2011-07-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
01046468A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200166030 | 05 |
| Street Address |
913 PLEASANT RIDGE CT |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47904-2784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568998615 | Angela Hands | Physical Therapy Assistant | 1260 North 17th Street, Lafayette, IN 47904 | 2017-05-11 |
| 1366894164 | Kathryn Barnett | Behavioral Analyst | 2785 Cason St # 2, Lafayette, IN 47904 | 2016-07-06 |
| 1881972917 | Rest Assured, LLC | Durable Medical Equipment & Medical Supplies | 180 Professional Ct., Lafayette, IN 47904 | 2011-07-22 |
| 1144514233 | Michelle Cristin Singleton | Dietitian, Registered | 508 N 26th St, Lafayette, IN 47904 | 2011-06-06 |
| 1912134438 | Jean D Trammel | Marriage & Family Therapist | 2000 Greenburg St, Bldg B, Suite A, Lafayette, IN 47904 | 2009-06-11 |
| 1902946056 | Terry Richard Baker | Optometrist | 2300 Sagamore Parkway S, Lafayette, IN 47904 | 2007-02-07 |
| 1891862165 | Becki A Bowditch Inc | Social Worker | 2201 Ferry Street, Lafayette, IN 47904 | 2006-11-29 |
| 1326121849 | James Lowell Thomas | Pediatrics | 2300 Ferry St, Lafayette, IN 47904 | 2006-10-21 |
| 1700976719 | Michael Leonard Bagnoli | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2006-10-13 |
| 1255428801 | Lynn Arlen Pestle | Dentist | 2550 Elmwood Avenue, Lafayette, IN 47904 | 2006-10-06 |
| Find all providers in zip 47904 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588295448 | Hassan Sawaf | Radiology | 1411 S Creasy Ln Ste 130, Lafayette, IN 47905-7433 | 2020-01-30 |
| 1801383245 | St Marys Imaging Center II | Radiology | 4809 Ambassador Caffery Pkwy Ste 350, Lafayette, LA 70508-8801 | 2018-04-20 |
| 1578937744 | Modesto Radiological Medical Group | Radiology | 2283 Hidden Pond Ln, Lafayette, CA 94549-1742 | 2015-11-25 |
| 1629411210 | Lowell David Froker | Radiology | 32 Olympic Oaks Dr, Lafayette, CA 94549-4800 | 2013-04-12 |
| 1386987196 | Imaging Partners Medical Group | Radiology | 3976 Canyon Rd, Lafayette, CA 94549-2702 | 2013-03-29 |
| 1982946562 | Rachael Lane Guillory | Radiology | 1811 Dulles Dr, Lafayette, LA 70506-3724 | 2013-03-21 |
| 1578811386 | Maurice Louis Bercier | Radiology | 309 Steiner Road, Lafayette, LA 70508 | 2012-08-28 |
| 1295024222 | Lourdes Imaging Center LLC | Radiology | 4809 Ambassador Caffery Parkway, Suite 350, Lafayette, LA 70508 | 2011-03-30 |
| 1467784744 | Delano Zeus Arvin | Radiology | 6233 N 700 E, Lafayette, IN 47905-9761 | 2010-02-11 |
| 1003045287 | Professional Radiology Network Tlc-prn, LLC | Radiology | 107 Kempton Dr, Lafayette, LA 70508-6547 | 2009-07-08 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.