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NPI Code Detail

MEDICARE: JOHNNY O ALEXANDER MD

MEDICARE: JOHNNY O ALEXANDER MD
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
12085R0202XDiagnostic Radiology PhysicianMD210012291DC
22085R0202XDiagnostic Radiology Physician0101243293VA
32085R0202XDiagnostic Radiology Physician36128037IL
42085R0202XDiagnostic Radiology Physician316970NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649439043
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHNNY O ALEXANDER MD
Provider Business Mailing Address
First Line : UVA HEALTH SERVICES FOUNDATION
Second Line : P.O. BOX 9007
City : CHARLOTTESVILLE
State : VA
Zip : 22908-0001
Country : US
Telephone Number : 434-295-1000
Fax Number : 434-972-4266
Provider Business Practice Location Address
First Line : 3753 S COTTAGE GROVE AVE STE 101
Second Line :
City : CHICAGO
State : IL
Zip : 60653-1662
Country : US
Telephone Number : 708-216-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2008
Last Update Date : 07/28/2025

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