Healthcare Provider Details

I. General information

NPI: 1497869143
Provider Name (Legal Business Name): JAMES LEE ALEXANDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 S MAIN ST
DAYTON OH
45402-2715
US

IV. Provider business mailing address

4341 E BRIGGS RD
BELLBROOK OH
45305-1575
US

V. Phone/Fax

Practice location:
  • Phone: 937-461-3387
  • Fax: 937-461-9217
Mailing address:
  • Phone: 937-848-7258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number35083655
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number01058424A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number17422
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberJ6062
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: