Healthcare Provider Details

I. General information

NPI: 1902627227
Provider Name (Legal Business Name): ALEXANDER JAMES BAUR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2024
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 SHADOW LN
LAS VEGAS NV
89106-4194
US

IV. Provider business mailing address

12536 SKYLIGHT VIEW ST
LAS VEGAS NV
89138-6191
US

V. Phone/Fax

Practice location:
  • Phone: 916-521-0352
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberSL2598
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: