Healthcare Provider Details

I. General information

NPI: 1790049229
Provider Name (Legal Business Name): ALEXANDER ESCOBAR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 HOSPITAL DR
TOLEDO OH
43614-8001
US

IV. Provider business mailing address

3000 ARLINGTON AVE STOP 1108
TOLEDO OH
43614-2595
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-6699
  • Fax: 419-383-3378
Mailing address:
  • Phone: 419-383-7100
  • Fax: 419-383-2000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number125061249
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number35.127953
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number35.127953
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: