Provider Demographics
NPI:1093159022
Name:ALEXANDER, ELAINE PATTERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:PATTERSON
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELAINE
Other - Middle Name:WILLETT
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1221 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2701
Mailing Address - Country:US
Mailing Address - Phone:859-258-6200
Mailing Address - Fax:859-258-6203
Practice Address - Street 1:1221 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2701
Practice Address - Country:US
Practice Address - Phone:859-258-4450
Practice Address - Fax:859-258-4039
Is Sole Proprietor?:No
Enumeration Date:2013-04-21
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP512207RR0500X
KY51332207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100545340Medicaid