MEDICARE: DR. JEFF ALEXANDER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	11911	OK

General Provider Information

NPI Number	:	1518964097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFF ALEXANDER M.D.

Provider Business Mailing Address
First Line	:	6565 S YALE AVE
Second Line	:	SUITE 503
City	:	TULSA
State	:	OK
Zip	:	74136-8378
Country	:	US
Telephone Number	:	918-494-8333
Fax Number	:	918-434-8334

Provider Business Practice Location Address
First Line	:	6565 S YALE AVE
Second Line	:	SUITE 503
City	:	TULSA
State	:	OK
Zip	:	74136-8378
Country	:	US
Telephone Number	:	918-494-8333
Fax Number	:	918-434-8334

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	03/31/2014

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