Provider Demographics
NPI:1356506380
Name:ANDRE OUTON, MD., P.C.
Entity type:Organization
Organization Name:ANDRE OUTON, MD., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:OUTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-674-1141
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-0127
Mailing Address - Country:US
Mailing Address - Phone:914-674-1141
Mailing Address - Fax:914-674-0048
Practice Address - Street 1:128 ASHFORD AVE
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1924
Practice Address - Country:US
Practice Address - Phone:914-674-1141
Practice Address - Fax:914-674-0048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty