Provider Demographics
NPI:1184640674
Name:DIGENIS, ALEXANDER GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:GEORGE
Last Name:DIGENIS
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 1027
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201
Mailing Address - Country:US
Mailing Address - Phone:502-589-5544
Mailing Address - Fax:502-561-0040
Practice Address - Street 1:315 E BROADWAY
Practice Address - Street 2:SUITE 1100 NORTON HEALTHCARE PAVILION
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202
Practice Address - Country:US
Practice Address - Phone:502-589-5544
Practice Address - Fax:502-561-0040
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28381KY2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64283815Medicaid
KY0977201Medicare ID - Type Unspecified
KY64283815Medicaid