MEDICARE: DR. ALBERT BARNARD ALEXANDER JR. PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	353	CO

General Provider Information

NPI Number	:	1063585438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT BARNARD ALEXANDER JR. PHD

Provider Business Mailing Address
First Line	:	8790 W COLFAX AVE
Second Line	:	SUITE 250
City	:	LAKEWOOD
State	:	CO
Zip	:	80215-4003
Country	:	US
Telephone Number	:	303-234-0827
Fax Number	:	303-234-1771

Provider Business Practice Location Address
First Line	:	8790 W COLFAX AVE
Second Line	:	SUITE 250
City	:	LAKEWOOD
State	:	CO
Zip	:	80215-4003
Country	:	US
Telephone Number	:	303-234-0827
Fax Number	:	303-234-1771

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	07/08/2007

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