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NPI Code Detail

MEDICARE: DR. ALEXANDROS GEORGOLIOS MD

MEDICARE: DR. ALEXANDROS GEORGOLIOS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology PhysicianTP526KY
2207Y00000XOtolaryngology Physician2013045551MO

General Provider Information

NPI Number : 1053571794
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXANDROS GEORGOLIOS MD
Provider Business Mailing Address
First Line : 79 VENIZELOU STREET
Second Line :
City : HOLARGOS
State : ATTIKI
Zip : 15561
Country : GR
Telephone Number : 012106545443
Fax Number :
Provider Business Practice Location Address
First Line : 3100 OAK GROVE RD
Second Line :
City : POPLAR BLUFF
State : MO
Zip : 63901-1573
Country : US
Telephone Number : 573-778-2600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2008
Last Update Date : 01/16/2025

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