Healthcare Provider Details

I. General information

NPI: 1679888994
Provider Name (Legal Business Name): VICTORIA R ALEXANDER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA R OHLIN D.O.

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 08/01/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 SEASONS RD SUITE 300
HUDSON OH
44224
US

IV. Provider business mailing address

231 SEASONS RD SUITE 300
HUDSON OH
44224
US

V. Phone/Fax

Practice location:
  • Phone: 330-662-5666
  • Fax: 330-655-3845
Mailing address:
  • Phone: 330-662-5666
  • Fax: 330-655-3845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34010760
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: