Healthcare Provider Details

I. General information

NPI: 1427152800
Provider Name (Legal Business Name): KEITH J ALEXANDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 01/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 NICHOLASVILLE ROAD SUITE 500
LEXINGTON KY
40503
US

IV. Provider business mailing address

1720 NICHOLASVILLE ROAD SUITE 500
LEXINGTON KY
40503
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-1114
  • Fax: 859-277-0541
Mailing address:
  • Phone: 859-278-1114
  • Fax: 859-277-0541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberKY26368
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: