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NPI Code Detail

MEDICARE: ALEX ANDERSON D.O.

MEDICARE: ALEX ANDERSON D.O.
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
1207Q00000XFamily Medicine Physician34.014388OH

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 : 1235662628
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEX ANDERSON D.O.
Provider Business Mailing Address
First Line : 1075 N WASHINGTON ST
Second Line :
City : GREENFIELD
State : OH
Zip : 45123-9780
Country : US
Telephone Number : 937-981-9444
Fax Number : 937-981-9448
Provider Business Practice Location Address
First Line : 1075 N WASHINGTON ST
Second Line :
City : GREENFIELD
State : OH
Zip : 45123-9780
Country : US
Telephone Number : 937-981-9444
Fax Number : 937-981-9448
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2017
Last Update Date : 07/16/2025

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