Provider Demographics
NPI:1033158209
Name:HORCHAK, ALEX M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:M
Last Name:HORCHAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 DELHI ST
Mailing Address - Street 2:SUITE 4300
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6358
Mailing Address - Country:US
Mailing Address - Phone:563-557-5971
Mailing Address - Fax:563-557-5973
Practice Address - Street 1:1500 DELHI ST
Practice Address - Street 2:SUITE 4300
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6358
Practice Address - Country:US
Practice Address - Phone:563-557-5971
Practice Address - Fax:563-557-5973
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC32513208800000X
NC2008-00739208800000X
AZ20134208800000X
IA40582208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC149HVOtherBCBS
SC325134Medicaid
AZ052283Medicaid
SC7399Medicare PIN
E75660Medicare UPIN
P00653107Medicare PIN