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General NPI Number Information
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NPI Number | 1194081422
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Entity Type | Individual
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Provider Name | ALEXCIS THOMSON FORD M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 11660 ALPHARETTA HWY STE 710
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City | ROSWELL
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State | GA
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Zip | 30076-4916
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Country | US
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Telephone | 678-344-8900
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Fax | 678-666-5201
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Provider Business Mailing Address
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Address Line | 1561 JANMAR RD
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City | SNELLVILLE
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State | GA
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Zip | 30078-5639
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Country | US
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Telephone | 678-344-8900
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Fax | 678-666-5201
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 076588
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 076588
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License Number State | GA
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