Healthcare Provider Details

I. General information

NPI: 1023004579
Provider Name (Legal Business Name): ALEXIS R. NADLER AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 10/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 W MARKET ST SUITE 333
LIMA OH
45801-4761
US

IV. Provider business mailing address

545 W MARKET ST SUITE 333
LIMA OH
45801-4761
US

V. Phone/Fax

Practice location:
  • Phone: 419-222-9010
  • Fax: 419-222-5496
Mailing address:
  • Phone: 419-222-9010
  • Fax: 419-222-5496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA00653
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2458335
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: