Healthcare Provider Details

I. General information

NPI: 1316905409
Provider Name (Legal Business Name): NADINE HELEN ALEX MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 01/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 HORSEBARN RD SUITE 203
ROGERS AR
72758-8795
US

IV. Provider business mailing address

593 HORSEBARN RD SUITE 203
ROGERS AR
72758-8795
US

V. Phone/Fax

Practice location:
  • Phone: 479-845-4707
  • Fax: 479-845-4708
Mailing address:
  • Phone: 479-845-4707
  • Fax: 479-845-4708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberE4690
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: