=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548479397
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ION ALEXIE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2007
-----------------------------------------------------
Last Update Date | 07/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 657 N TOWN CENTER DR
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89144-6367
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-800-6692
-----------------------------------------------------
Fax | 702-948-4954
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 80783
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89180-0783
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-228-5800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ION ALEXIE
-----------------------------------------------------
Credential | ME
-----------------------------------------------------
Telephone | 702-884-6826
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RI0200X
-----------------------------------------------------
Taxonomy Name | Infectious Disease Physician
-----------------------------------------------------
License Number | 7961
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------