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NPI Code Detail

MEDICARE: DR ALEXANDER L.L.C

MEDICARE: DR ALEXANDER L.L.C
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
1174400000XSpecialistNM99-1NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104846013
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR ALEXANDER L.L.C
Provider Business Mailing Address
First Line : 1040 SAKELARES BLVD
Second Line :
City : GRANTS
State : NM
Zip : 87020-3819
Country : US
Telephone Number : 505-287-4489
Fax Number : 505-287-8441
Provider Business Practice Location Address
First Line : 1040 SAKELARES BLVD
Second Line :
City : GRANTS
State : NM
Zip : 87020-3819
Country : US
Telephone Number : 505-287-4489
Fax Number : 505-287-8441
Authorized Official
Title or Position : BILLING CLERK
Name : MS. JUDY A GALLEGOS
Credential :
Telephone Number : 505-287-4489
Provider Enumeration Date : 07/21/2006
Last Update Date : 05/16/2008

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Directions to “DR ALEXANDER L.L.C ” Practice Location

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