Provider Demographics
NPI:1164089058
Name:ALEXANDER, EBEN IV (DO)
Entity Type:Individual
Prefix:DR
First Name:EBEN
Middle Name:
Last Name:ALEXANDER
Suffix:IV
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5124 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2290
Mailing Address - Country:US
Mailing Address - Phone:412-359-8191
Mailing Address - Fax:
Practice Address - Street 1:107 S SPORTING HILL RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-3058
Practice Address - Country:US
Practice Address - Phone:717-943-1781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-26
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102207354208100000X
PAOS023243208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation