Individual
JOHN D ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CO004822
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000973794C
—
GA
05
—
000973794D
—
GA
05
—
000973794E
—
GA
05
—
1455062
—
TN
05
—
1507472
—
TN
Enumeration date
09/15/2010
Last updated
09/15/2010
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