Healthcare Provider Details

I. General information

NPI: 1699091306
Provider Name (Legal Business Name): JOSEPH F ALEXANDER JR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 04/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3090 W MARKET ST SUITE
FAIRLAWN OH
44333-3608
US

IV. Provider business mailing address

3090 W MARKET ST SUITE 110
FAIRLAWN OH
44333-3608
US

V. Phone/Fax

Practice location:
  • Phone: 330-836-7110
  • Fax: 330-836-7423
Mailing address:
  • Phone: 330-836-7110
  • Fax: 330-836-7423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number35039562
License Number StateOH

VIII. Authorized Official

Name: MRS. RASHELLE ROSE SPONSELLER
Title or Position: MA/OFFICE MANAGER
Credential:
Phone: 330-836-7110