Healthcare Provider Details

I. General information

NPI: 1477468304
Provider Name (Legal Business Name): TONYOUR M ALEXANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S PATTERSON ST
VALDOSTA GA
31601-5608
US

IV. Provider business mailing address

4301 BEMISS RD APT B301
VALDOSTA GA
31605-6132
US

V. Phone/Fax

Practice location:
  • Phone: 229-834-9498
  • Fax:
Mailing address:
  • Phone:
  • Fax: 122-983-4949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: