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Individual

ALISA JOCELYN ALEXANDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 451-6682
(907) 459-3811
Mailing address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 451-6682
(907) 459-3811

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7468
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1579583
AK
01
MEDS7468
ALASKA STATE LICENSE
AK
Enumeration date
01/09/2012
Last updated
12/20/2016
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