Provider Demographics
NPI:1073595989
Name:ALEXANDER, LON F (MD)
Entity Type:Individual
Prefix:
First Name:LON
Middle Name:F
Last Name:ALEXANDER
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:PO BOX 3087
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-3087
Mailing Address - Country:US
Mailing Address - Phone:985-230-3668
Mailing Address - Fax:985-370-7409
Practice Address - Street 1:15784 MEDICAL ARTS DR STE B
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1474
Practice Address - Country:US
Practice Address - Phone:985-230-7400
Practice Address - Fax:985-230-7401
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS10954207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00118703Medicaid
730-09296OtherBLUE CROSS OF AL
140008223OtherRAILROAD MEDICARE
AL009910255Medicaid
AL009910255Medicaid
MS512I140032Medicare PIN