MEDICARE: DR. ALEXANDER VILLARES 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
1	208600000X	Surgery Physician	32704	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1730155086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER VILLARES MD

Provider Business Mailing Address
First Line	:	3811 E BELL RD STE 206
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2159
Country	:	US
Telephone Number	:	480-725-8627
Fax Number	:	480-725-8629

Provider Business Practice Location Address
First Line	:	3811 E BELL RD STE 206
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2159
Country	:	US
Telephone Number	:	480-725-8627
Fax Number	:	480-725-8629

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	01/23/2015

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