Koutlas, Theodore C
Koutlas, Theodore C is an individual health care provider with primary practice located at 62 W 7Th Ave Ste 110 , Spokane WA 99204-2321. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Koutlas, Theodore C can be contacted via phone (509) 456-0262.Contact Information
Primary practice address
62 W 7Th Ave Ste 110
Spokane WA 99204-2321
Phone: (509) 456-0262
Fax: (509) 462-5059
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | M-12098 | Idaho |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 36754 | North Carolina |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | MD60367366 | Washington |
Profile Details
| NPI number | 1902898331 |
|---|---|
| LBN Legal business name | Koutlas, Theodore C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 22nd, 2005 |
| Last updated | Jun 16th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902898331 | NPPES |
| North Carolina | Other | 330004170 | RAILROAD MEDICARE |
| North Carolina | MEDICAID | 8950281 | RAILROAD MEDICARE |
| North Carolina | Other | 50281 | RAILROAD MEDICARE |
Popular Providers
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Siwek, Leland G.
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62 W 7Th Ave Ste 110 , Spokane WA 99204-2321