Provider Demographics
NPI:1225082159
Name:JOHN E ALEXANDER JR MD PA
Entity Type:Organization
Organization Name:JOHN E ALEXANDER JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALEXANDER JR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-234-2144
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71754-0129
Mailing Address - Country:US
Mailing Address - Phone:870-234-2144
Mailing Address - Fax:870-234-2149
Practice Address - Street 1:104 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753
Practice Address - Country:US
Practice Address - Phone:870-234-2144
Practice Address - Fax:870-234-2149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC5751207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR101600001Medicaid
AR50071OtherBCBS
AR50071Medicare PIN
AR101600001Medicaid