Healthcare Provider Details

I. General information

NPI: 1073754321
Provider Name (Legal Business Name): ALEXANDER FRANCISCO BAUTISTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5TH FLOOR HAFS DUMC 3094
DURHAM NC
27710-0001
US

IV. Provider business mailing address

5TH FLOOR HAFS DUMC 3094
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-6493
  • Fax:
Mailing address:
  • Phone: 919-681-6493
  • Fax: 919-681-6493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number01074052A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01074052A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number52172
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number31063
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: