Provider Demographics
NPI:1710206057
Name:GAUTHIER, ALEXANDRE F (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDRE
Middle Name:F
Last Name:GAUTHIER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 N HILL DR STE 202
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2677
Mailing Address - Country:US
Mailing Address - Phone:540-349-1882
Mailing Address - Fax:703-738-7157
Practice Address - Street 1:45 N HILL DR STE 202
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2677
Practice Address - Country:US
Practice Address - Phone:540-349-1882
Practice Address - Fax:703-738-7157
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255729207W00000X, 207WX0107X, 207W00000X
FLME127152207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1710206057Medicaid
MD0799203 00Medicaid
DC066323900Medicaid
MD0799203 00Medicaid
DC358393ZA9WMedicare UPIN