Phillip G. Koultourides, O.D. P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003080 Issued in IN

Legal business name

PHILLIP G. KOULTOURIDES, O.D. P.C.

Practice address

2400 Morthland Dr
Valparaiso, IN 46383-8329

Phone

(219) 465-2788

Fax

(219) 465-2785

NPI assigned

Nov 1, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Phillip Koultourides, O.D.NPI 1295847986

Title

President

Phone

(219) 365-8069

Specialties & licenses 1

Addresses

Tax ID family

Phillip G Koultourides OD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Phillip G Koultourides, O.D. P.C.

  • Optometrist
  • Schererville, IN
  • NPI 1316567134
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phillip George Koultourides, O.D.

  • Optometrist
  • Valparaiso, IN
  • NPI 1295847986
  NPD (past) Authorized official

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

{
    "created_epoch": "1257033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257033600000",
    "number": "1508192147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9140 DRAKE DR",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463739066",
            "telephone_number": "219-365-8069",
            "fax_number": "219-465-2785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MORTHLAND DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463838329",
            "telephone_number": "219-465-2788",
            "fax_number": "219-465-2785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP G. KOULTOURIDES, O.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-01",
        "last_updated": "2009-11-01",
        "status": "A",
        "authorized_official_last_name": "KOULTOURIDES",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-365-8069",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Eich Peyton, MS, OTR/L
• Satish Dolly Phadke, PT
• Winna Pham, DDS
• Pharma - Card Inc
• Anna Philipose
• Joel Phillips, FNP
• Physical Therapy Solutions LLC
• Physicians for Women PC
• Ruolan Lori Pi, MD
• Maria Lisa Pickell, RPH

• Optometrist in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2009; 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.