Individual
ALEXANDER FACISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1907 W SYCAMORE ST, KOKOMO, IN 46901-5148
(765) 456-5433
Mailing address
250 W 96TH ST # 520, INDIANAPOLIS, IN 46260-1316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01081040A
IN
Other
Enumeration date
05/24/2016
Last updated
11/21/2018
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