Provider Demographics
NPI:1164154274
Name:BATTAGLIA, ALIXANDRA SEBRECHTS (DO)
Entity Type:Individual
Prefix:
First Name:ALIXANDRA
Middle Name:SEBRECHTS
Last Name:BATTAGLIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 MEMORIAL AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2652
Mailing Address - Country:US
Mailing Address - Phone:143-420-0615
Mailing Address - Fax:
Practice Address - Street 1:2323 MEMORIAL AVE STE 10
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2652
Practice Address - Country:US
Practice Address - Phone:143-420-0615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116035169390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA207Q0000XOtherFAMILY MEDICINE