Provider Demographics
NPI:1033505086
Name:BOTTINI, ALEXANDER R (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:R
Last Name:BOTTINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1255 FRIENDSHIP RD STE 160
Mailing Address - Street 2:
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-5618
Mailing Address - Country:US
Mailing Address - Phone:678-528-1101
Mailing Address - Fax:678-528-3254
Practice Address - Street 1:1255 FRIENDSHIP RD STE 160
Practice Address - Street 2:
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-5618
Practice Address - Country:US
Practice Address - Phone:678-528-1101
Practice Address - Fax:678-528-3254
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2023-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2019014155207W00000X, 207WX0107X
GA87920207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology