Healthcare Provider Details
I. General information
NPI: 1801140728
Provider Name (Legal Business Name): WILLIAM S. ALEXANDER, M.D.,P.L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/30/2012
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3443 HARRISON ST
BATESVILLE AR
72501-8820
US
IV. Provider business mailing address
3443 HARRISON ST
BATESVILLE AR
72501-8820
US
V. Phone/Fax
- Phone: 870-698-1635
- Fax: 870-793-3196
- Phone: 870-698-1635
- Fax: 870-793-3196
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | C6366 |
| License Number State | AR |
VIII. Authorized Official
Name:
WILLIAM
S
ALEXANDER
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 870-698-1635