Individual
ALEXANDER KOTUKHOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7641
(503) 494-4661
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE SJH-2, PORTLAND, OR 97239-1837
(503) 494-7246
(503) 494-8368
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
54039
KY
207L00000X
Anesthesiology Physician
Primary
MD213814
OR
208600000X
Surgery Physician
125.067855
IL
Other
Enumeration date
07/10/2015
Last updated
07/06/2023
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