Provider Demographics
NPI:1104025584
Name:MARION, ALEXANDER DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:DOUGLAS
Last Name:MARION
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:104 SIMPSON ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4413
Practice Address - Country:US
Practice Address - Phone:864-522-3900
Practice Address - Fax:864-522-3909
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11432207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC114325Medicaid
SC0534530001OtherMEDICARE DME
SC114325Medicaid
SC0534530001OtherMEDICARE DME