Healthcare Provider Details

I. General information

NPI: 1750804092
Provider Name (Legal Business Name): DEBORAH LANETTE ALEXANDER HAIR SPECIALIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBORAH L ALEXANDER HAIR LOSS SPECIALIST

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 07/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 FLORETINE DR.
BIRMINGHAM AL
35215
US

IV. Provider business mailing address

827 FLORETINE DR.
BIRMINGHAM AL
35215
US

V. Phone/Fax

Practice location:
  • Phone: 205-593-3320
  • Fax:
Mailing address:
  • Phone: 205-593-3320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: