Provider Demographics
NPI:1104852557
Name:JEFF ALEXANDER, MD, PC
Entity type:Organization
Organization Name:JEFF ALEXANDER, MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-494-8333
Mailing Address - Street 1:6565 S YALE AVE
Mailing Address - Street 2:STE 503
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8378
Mailing Address - Country:US
Mailing Address - Phone:918-494-8333
Mailing Address - Fax:918-494-8334
Practice Address - Street 1:6565 S YALE AVE
Practice Address - Street 2:STE 503
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8378
Practice Address - Country:US
Practice Address - Phone:918-494-8333
Practice Address - Fax:918-494-8334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11911174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty