Healthcare Provider Details

I. General information

NPI: 1174583231
Provider Name (Legal Business Name): JOEL J ALEXANDER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 N PARK PL SE STE 550
ATLANTA GA
30339-2228
US

IV. Provider business mailing address

925 N POINT PKWY STE 130
ALPHARETTA GA
30005-5211
US

V. Phone/Fax

Practice location:
  • Phone: 770-740-1860
  • Fax: 678-347-2104
Mailing address:
  • Phone: 678-206-2589
  • Fax: 678-261-1713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number029570
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: