Provider Demographics
NPI:1134105182
Name:ALEXANDER, EDWARD G JR (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:G
Last Name:ALEXANDER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73101-0284
Mailing Address - Country:US
Mailing Address - Phone:405-590-9780
Mailing Address - Fax:703-842-6136
Practice Address - Street 1:1650 MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-3046
Practice Address - Country:US
Practice Address - Phone:580-254-8600
Practice Address - Fax:580-571-8085
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101021433207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
540911540OtherTRICARE
100373OtherHEALTHKEEPERS
100373053384OtherBLUE CROSS
0502703OtherAETNA US HEALTHCARE
290291OtherAMERIGROUP MEDICAID
VA006456472Medicaid
25530019OtherCAREFIRST
0900083OtherUNITED HEALTHCARE
100373OtherANTHEM HMO
200025897OtherTRAVELERS MEDICARE
28704OtherGOVT EMPLOYEE HEALTH ASS
3845275007OtherCIGNA HEALTHCARE HMO
540911540OtherCIGNA PPO
103789000OtherFED GOVT DEPT OF LABOR
4080959OtherAETNA MANAGED
25530019OtherCAPITAL CARE
28704OtherALLIANCE PPO
38704OtherMDIPA
540911540OtherCIGNA PPO
200025897OtherTRAVELERS MEDICARE