Provider Demographics
NPI:1033192034
Name:JOHNSON, ALEX WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:WILLIAM
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 FRANKLIN ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4551
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN551732085R0204X
AL196512085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL111353Medicaid
AL247711Medicaid
AL009942880Medicaid
AL247842Medicaid
AL248364Medicaid
AL009911521Medicaid
AL111349Medicaid
AL127009Medicaid
AL136472Medicaid
AL247826Medicaid
AL51595081OtherBCBS
AL51595532OtherBCBS
AL51595535OtherBCBS
AL111350Medicaid
AL249139Medicaid
AL51067341OtherBCBS
AL51595533OtherBCBS
AL51595534OtherBCBS
AL111351Medicaid
AL111352Medicaid
AL247705Medicaid
AL247950Medicaid
AL51595536OtherBCBS
AL51595531OtherBCBS