Provider Demographics
NPI:1306836549
Name:TON, MD, ALEXANDER L (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:L
Last Name:TON, MD
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 1:4757 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4559
Mailing Address - Country:US
Mailing Address - Phone:812-234-2289
Mailing Address - Fax:812-232-4234
Practice Address - Street 1:4757 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4559
Practice Address - Country:US
Practice Address - Phone:812-234-2289
Practice Address - Fax:812-232-4234
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039701A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100252780Medicaid
IN176980AMedicare ID - Type UnspecifiedINDIVIDUAL #
IN100252780Medicaid
IN136610Medicare ID - Type UnspecifiedGROUP #
F12674Medicare UPIN
IN176980Medicare ID - Type UnspecifiedGROUP #