NPIMap

Individual provider Active NPI

George T Koulianos, MD

  • Reproductive Endocrinology Physician
  • Mobile, AL
National Provider Identifier
1083643142
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
15405 Issued in AL
Practice address
3 Mobile Infirmary Cir
Suite 213
Mobile, AL 36607-3520
Phone
(251) 438-4200
Fax
(251) 438-4211
NPI assigned
Jul 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 15405 AL Primary

Addresses

Primary practice location

3 Mobile Infirmary Cir
Suite 213
Mobile, AL 36607-3520

Mailing address

3 Mobile Infirmary Cir
Suite 213
Mobile, AL 36607-3520
Phone (251) 438-4200

Other identifiers 2

IdentifierTypeStateIssuer
88782OtherALBLUE CROSS
051088782MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15405ALMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Reproductive Medicine Reproductive Endocrinology Past Accepting new patients
CRM Alabama, LLC Reproductive Endocrinology Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1083643142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MOBILE INFIRMARY CIR",
            "address_2": "SUITE 213",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366073520",
            "telephone_number": "251-438-4200",
            "fax_number": "251-438-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MOBILE INFIRMARY CIR",
            "address_2": "SUITE 213",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366073520",
            "telephone_number": "251-438-4200",
            "fax_number": "251-438-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOULIANOS",
        "first_name": "GEORGE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "AL",
            "license": "15405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "88782",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051088782",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.