MARTIN LEBOUTILLIER III (NPI# 1831152651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831152651 |
| Entity Type | Individual |
| Full Name | MARTIN LEBOUTILLIER III |
| Credential | M.D. |
| Practice Address |
Fourth & Walnut Sts 2nd Fl Lebanon PA 17042-1281 |
| Practice Telephone | 7172703751 |
| Practice Fax Number | 7172703754 |
| Mailing Telephone | 7172703751 |
| Mailing Fax Number | 7172703754 |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2016-07-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | MD065743L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | AMERIHEALTH MERCY-WMG | 30139141 | 01 |
| MD | 058255700 | 05 | |
| PA | HIGHMARK BLUE SHIELD | 976216 | 01 |
| PA | 001708549 | 05 | |
| PA | GATEWAY | 1511587 | 01 |
| Street Address |
FOURTH & WALNUT STS 2ND FL |
| City | LEBANON |
| State | PA |
| Zip Code | 17042-1281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023676384 | Sandra L Pistone | Registered Nurse | 905 S. 2nd Ave, Lebanon, PA 17042 | 2019-06-03 |
| 1154848414 | Kihc, LLC | Home Health | 900-c Centerville Road, Suite C, Lancaster, PA 17042 | 2017-08-28 |
| 1316301724 | Good Samaritan Physician Services | Radiology | 844 Tuck Street, Lebanon, PA 17042 | 2016-04-12 |
| 1609265883 | Ashley Hess | Behavioral Analyst | 15th South 9th Street, Lebanon, PA 17042 | 2015-01-12 |
| 1932504727 | Anthony Salvadore Petrole | Physician Assistant | 252 4th Street, Lebanon, PA 17042 | 2014-10-23 |
| 1801209713 | Matthew Johnson | Family Medicine | 920 Church Street, Lebanon, PA 17042 | 2014-06-09 |
| 1437414505 | Odalys Gonzalez-rodriguez | Physical Therapist | 1700 S Lincoln Ave., Lebanon Vmac Bldg 102 Room 120, Lebanon, PA 17042 | 2012-07-05 |
| 1750677175 | Anita Lyn Stokes | Speech-Language Pathologist | 1126 Walnut Street, Lebanon, PA 17042 | 2011-06-23 |
| 1205126497 | Karey Lynn Foote | Pharmacist | 415 S. 9th St, Lebanon, PA 17042 | 2011-04-09 |
| 1013227685 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 101 E. Evergreen Road, Lebanon, PA 17042 | 2010-10-18 |
| Find all providers in zip 17042 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871565077 | Aristides Basil Codoyannis | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 13 Glennon Farm Ln, Lebanon, NJ 08833-4504 | 2006-02-02 |
| 1013912070 | Savas Mavridis | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 252 S 4th St Fl 2, Lebanon, PA 17042 | 2005-06-16 |
| 1407096951 | Good Samaritan Physician Services | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4th & Walnut Streets, 2nd Floor, Lebanon, PA 17042-6123 | 2009-02-24 |
| 1376709543 | Joseph David Phillips | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 Medical Center Dr, Dartmouth Hitchcock - Thoracic Surgery, Lebanon, NH 03756 | 2008-08-06 |
| 1750557724 | Rian Melissa Hasson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 Medical Center Dr, Lebanon, NH 03756 | 2008-04-30 |
| 1326213372 | Bryan Payne Stanifer | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 Medical Center Dr, Dhmc Department of Surgery, Lebanon, NH 03756-1000 | 2008-04-29 |
| 1619162427 | David J Finley | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 Medical Center Dr, Dhmc - Thoracic Surgery, Lebanon, NH 03756-1000 | 2007-09-14 |
| 1528118643 | Joseph Paul Desimone | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 Medical Center Dr, Dhmc Cardiac Surgery, Lebanon, NH 03756-1000 | 2007-01-11 |
| 1598773962 | Cardiovascular Surgical Associates of Lebanon, Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Fourth and Walnut Streets, Lebanon, PA 17042 | 2006-08-03 |
| 1063440253 | Anthony W Discipio | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-06-28 |
| Find all providers in LEBANON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.