Healthcare Provider Details

I. General information

NPI: 1609300136
Provider Name (Legal Business Name): ALEXANDER LEIGH NOURSE D.O., M.B.A., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ST LUKES LN
STROUDSBURG PA
18360-6217
US

IV. Provider business mailing address

100 ST LUKES LN
STROUDSBURG PA
18360-6217
US

V. Phone/Fax

Practice location:
  • Phone: 610-393-2535
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number3831
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS025489
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number3831
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: