Provider Demographics
NPI:1114069176
Name:ALEXANDER, KARA (OD)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22318 FORD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2421
Mailing Address - Country:US
Mailing Address - Phone:313-565-6565
Mailing Address - Fax:313-565-0579
Practice Address - Street 1:22318 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2421
Practice Address - Country:US
Practice Address - Phone:313-565-6565
Practice Address - Fax:313-565-0579
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004303152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist