Provider Demographics
NPI:1194013029
Name:ALIX, DENIS R (MD)
Entity Type:Individual
Prefix:DR
First Name:DENIS
Middle Name:R
Last Name:ALIX
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 1:7540 CONSERVATION ST NE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-9522
Mailing Address - Country:US
Mailing Address - Phone:616-676-8826
Mailing Address - Fax:
Practice Address - Street 1:7540 CONSERVATION ST NE
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MI
Practice Address - Zip Code:49301-9522
Practice Address - Country:US
Practice Address - Phone:616-676-8826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1669925208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice