Healthcare Provider Details

I. General information

NPI: 1144256017
Provider Name (Legal Business Name): JOHN ALEXANDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 22ND AVENUE MONROE CLINIC
MONROE WI
53566-1569
US

IV. Provider business mailing address

5666 E STATE ST
ROCKFORD IL
61108-2472
US

V. Phone/Fax

Practice location:
  • Phone: 608-324-2222
  • Fax: 815-227-2880
Mailing address:
  • Phone: 815-381-7715
  • Fax: 815-227-2880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number49402
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number036111220
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: