John L. Roussalis M.D., P.C.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

7691A Issued in WY

Legal business name

JOHN L. ROUSSALIS M.D., P.C.

Practice address

1129 E 2ND St
Casper, WY 82601-2903

Phone

(307) 234-4585

Fax

(307) 265-7479

NPI assigned

Oct 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Louis Roussalis, M.D.

Title

President

Phone

(307) 234-4585

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315353600000",
    "number": "1205025624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 E 2ND ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012903",
            "telephone_number": "307-234-4585",
            "fax_number": "307-265-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 E 2ND ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012903",
            "telephone_number": "307-234-4585",
            "fax_number": "307-265-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN L. ROUSSALIS M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2011-09-07",
        "status": "A",
        "authorized_official_last_name": "ROUSSALIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-234-4585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "WY",
            "license": "7691A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy Lee Jindrick-Tholl, LPC
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• John L Bouzis
• Alexia Lein Johnson, RRT
• Beth Johnson, CCMA
• Callie J Johnson, PT, DPT
• Carol Ann Johnson
• Chellsie D Johnson, M.ED, ATC

• Plastic Surgery Physician in Casper, WY
• Providers in Casper, WY by specialty
• Plastic Surgery Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.