Provider Demographics
NPI:1134514623
Name:KISH, ALEXANDER JOHN (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:JOHN
Last Name:KISH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1861 POWDER MILL ROAD
Mailing Address - Street 2:ATTN MEDICAL STAFF OFFICE
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-4723
Mailing Address - Country:US
Mailing Address - Phone:717-718-2041
Mailing Address - Fax:717-747-2102
Practice Address - Street 1:470 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-5248
Practice Address - Country:US
Practice Address - Phone:717-633-0031
Practice Address - Fax:717-630-1085
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD473092207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery