Healthcare Provider Details

I. General information

NPI: 1316292071
Provider Name (Legal Business Name): ALEX J VRABLE JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 06/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1638 OWEN DR
FAYETTEVILLE NC
28304-3424
US

IV. Provider business mailing address

PO BOX 53844
FAYETTEVILLE NC
28305-3844
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-1313
  • Fax: 919-323-5795
Mailing address:
  • Phone: 919-323-1313
  • Fax: 919-323-5795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2016-00870
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number2016-00870
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: