Provider Demographics
NPI:1295841963
Name:THOMAS C. ALEXANDER, M.D., INC.
Entity Type:Organization
Organization Name:THOMAS C. ALEXANDER, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CRAWFORD
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-756-5471
Mailing Address - Street 1:1212 S BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-6310
Mailing Address - Country:US
Mailing Address - Phone:918-756-5471
Mailing Address - Fax:918-756-5498
Practice Address - Street 1:1212 S BELMONT AVE
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-6310
Practice Address - Country:US
Practice Address - Phone:918-756-5471
Practice Address - Fax:918-756-5498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8128207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK$$$$$$$$$OtherSSN
OH100109390AMedicaid
OK444322851001OtherBCBS PROVIDER
OK0060321OtherUNITED MINE WORKERS
OK50657OtherBLUE LINCS PROVIDER
OK112859759OtherRAILROAD MEDICARE
OK444302851Medicare PIN