Healthcare Provider Details

I. General information

NPI: 1003017989
Provider Name (Legal Business Name): ALEXANDER TOPALA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ALEXANDER TOPALA SR. MD

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 06/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST MAIL LOCATION 0796
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

PO BOX 636256 CENTRAL CREDENTIALING
CINCINNATI OH
45263-6256
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-1000
  • Fax:
Mailing address:
  • Phone: 513-585-5502
  • Fax: 513-585-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number57011171
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: