Provider Demographics
NPI:1093368243
Name:ALEXANDER, KEVIN ALBRE
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:ALBRE
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W ARCHER ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74103-1807
Mailing Address - Country:US
Mailing Address - Phone:346-283-6859
Mailing Address - Fax:
Practice Address - Street 1:415 W ARCHER ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-1807
Practice Address - Country:US
Practice Address - Phone:346-283-6859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist