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NPI Code Detail

MEDICARE: DR. ALEX GARY RAYMOND DO

MEDICARE: DR. ALEX GARY RAYMOND DO
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
1207X00000XOrthopaedic Surgery PhysicianOT017682PA
2390200000XStudent in an Organized Health Care Education/Training ProgramOT017682PA
3207X00000XOrthopaedic Surgery PhysicianOS019604PA

General Provider Information

NPI Number : 1114447182
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEX GARY RAYMOND DO
Provider Business Mailing Address
First Line : 711 LOGAN BLVD
Second Line :
City : ALTOONA
State : PA
Zip : 16602-4165
Country : US
Telephone Number : 814-943-3668
Fax Number :
Provider Business Practice Location Address
First Line : 711 LOGAN BLVD
Second Line :
City : ALTOONA
State : PA
Zip : 16602-4165
Country : US
Telephone Number : 814-943-3668
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2017
Last Update Date : 11/05/2023

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1528027794 — WILLIAM J WIEDEMER D.P.M.
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711 LOGAN BLVD
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1033159538 — DR. MATTHEW T SABOL D.P.M.
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1376811570 — GARY A RAYMOND DPM PC
Practice Location Address:
711 LOGAN BLVD
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16602-4165
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Practice Fax: 814-942-7635

Directions to “ DR. ALEX GARY RAYMOND DO” Practice Location

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