DR. VIKTOR BOUQUETTE M.D. NPI 1073730552

NPI Information

  • NPI: 1073730552
  • Provider Name: DR. VIKTOR BOUQUETTE, M.D.
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4646 N. SHALLOWFORD ROAD
    ATLANTA, GA
    ZIP 30338
  • Phone: (770) 676-6000

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NPI Details

DR. Viktor Bouquette, M.D. is a specialist in Atlanta, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Viktor Bouquette, M.D. NPI is 1073730552. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4646 N. SHALLOWFORD ROAD
ATLANTA, GA
ZIP 30338
Phone: (770) 676-6000
Fax: (770) 392-9805

The NPI 1073730552 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/19/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist026769GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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