Healthcare Provider Details

I. General information

NPI: 1215626684
Provider Name (Legal Business Name): PATRICIA P ALEXANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 S BURNETT RD STE 210
SPRINGFIELD OH
45505-2663
US

IV. Provider business mailing address

247 S BURNETT RD STE 210
SPRINGFIELD OH
45505-2663
US

V. Phone/Fax

Practice location:
  • Phone: 937-328-8850
  • Fax: 937-328-8860
Mailing address:
  • Phone: 937-328-8850
  • Fax: 937-328-8860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.156476
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: