Healthcare Provider Details

I. General information

NPI: 1235046707
Provider Name (Legal Business Name): MR. ALEXANDER PERKINS CHANEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3006 DELMAR LN NW APT G10
ATLANTA GA
30311-1152
US

IV. Provider business mailing address

3006 DELMAR LN NW APT G10
ATLANTA GA
30311-1152
US

V. Phone/Fax

Practice location:
  • Phone: 770-865-7722
  • Fax: 404-806-6662
Mailing address:
  • Phone: 770-865-7722
  • Fax: 404-806-6662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number26-536332
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: