Healthcare Provider Details

I. General information

NPI: 1295493765
Provider Name (Legal Business Name): ALEXANDER CALHOUN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2021
Last Update Date: 12/02/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL WAY
BUTLER PA
16001-4670
US

IV. Provider business mailing address

PO BOX 737
EAST BUTLER PA
16029-0737
US

V. Phone/Fax

Practice location:
  • Phone: 724-283-6666
  • Fax:
Mailing address:
  • Phone: 724-256-9700
  • Fax: 724-256-9705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number139222
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: