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NPI Code Detail

MEDICARE: TERENCE ANTHONY ALEXANDER M.D.

MEDICARE: TERENCE ANTHONY ALEXANDER M.D.
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
1207XX0005XSports Medicine (Orthopaedic Surgery) Physician27628IA
2207XX0005XSports Medicine (Orthopaedic Surgery) Physician29782WI
3207XX0005XSports Medicine (Orthopaedic Surgery) Physician51325AZ

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 : 1629028410
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERENCE ANTHONY ALEXANDER M.D.
Provider Business Mailing Address
First Line : PO BOX 271429
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-1429
Country : US
Telephone Number : 602-772-3800
Fax Number : 602-772-3801
Provider Business Practice Location Address
First Line : 10450 W MCDOWELL RD
Second Line : SUITE 102
City : AVONDALE
State : AZ
Zip : 85392-4901
Country : US
Telephone Number : 623-846-7614
Fax Number : 623-846-0993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 11/03/2016

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