Healthcare Provider Details

I. General information

NPI: 1093992588
Provider Name (Legal Business Name): HERBERT D ALEXANDER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6470 E JOHNS XING STE 200
JOHNS CREEK GA
30097-1539
US

IV. Provider business mailing address

PO BOX 2330
BLUFFTON SC
29910-2330
US

V. Phone/Fax

Practice location:
  • Phone: 470-282-5729
  • Fax:
Mailing address:
  • Phone: 843-837-4400
  • Fax: 843-837-4440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number000921
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: