Provider Demographics
NPI:1144390139
Name:ALEXANDER, KERRY A (MD)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:A
Last Name:ALEXANDER
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:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-886-6259
Mailing Address - Fax:540-885-1696
Practice Address - Street 1:42 LAMBERT STREET SUITE 511
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401
Practice Address - Country:US
Practice Address - Phone:540-866-6259
Practice Address - Fax:540-885-1696
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046560207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA064430OtherANTHEM
VA6044034Medicaid
VA08104500000OtherSOUTHERN HEALTH
VA08104500000OtherSOUTHERN HEALTH
VA08104500000OtherSOUTHERN HEALTH