Healthcare Provider Details

I. General information

NPI: 1083989362
Provider Name (Legal Business Name): GUY THOMAS ALEXANDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 06/05/2021
Certification Date: 06/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1024 S LEMAY AVE
FORT COLLINS CO
80524-3929
US

IV. Provider business mailing address

2008 CARIBOU DR
FORT COLLINS CO
80525-4325
US

V. Phone/Fax

Practice location:
  • Phone: 970-495-7000
  • Fax:
Mailing address:
  • Phone: 970-484-4757
  • Fax: 970-484-4759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number13302A
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberR7944
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number33216
License Number StateNE
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberDR.0065457
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: