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NPI Code Detail

MEDICARE: JUSTIN ALEXANDER LLC

MEDICARE: JUSTIN ALEXANDER LLC
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
1208100000XPhysical Medicine & Rehabilitation PhysicianGA

General Provider Information

NPI Number : 1285018978
Entity Type Code : Organization
Provider Name (Legal Business Name) : JUSTIN ALEXANDER LLC
Provider Business Mailing Address
First Line : 1 GLENLAKE PKWY
Second Line : SUITE 700
City : ATLANTA
State : GA
Zip : 30328-3448
Country : US
Telephone Number : 205-427-4375
Fax Number :
Provider Business Practice Location Address
First Line : 1 GLENLAKE PKWY
Second Line : SUITE 700
City : ATLANTA
State : GA
Zip : 30328-3448
Country : US
Telephone Number : 205-427-4375
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. JUSTIN ALEXANDER
Credential : M.D.
Telephone Number : 205-427-4375
Provider Enumeration Date : 07/13/2015
Last Update Date : 12/11/2015

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