Organization
BLAKE D. ALEXANDER, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE D. ALEXANDER MD (PRESIDENT)
(208) 236-1600
Entity
Organization
Contact information
Practice address
500 S 11TH AVE, SUITE 203, POCATELLO, ID 83201-4835
(208) 236-1600
(208) 236-6695
Mailing address
PO BOX 4908, POCATELLO, ID 83205-4908
(208) 236-1600
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M8227
ID
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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