Provider Demographics
NPI:1346485794
Name:LON F ALEXANDER MD PLLC
Entity Type:Organization
Organization Name:LON F ALEXANDER MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LON
Authorized Official - Middle Name:F
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-376-2199
Mailing Address - Street 1:1860 CHADWICK DR STE 205
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39204-3466
Mailing Address - Country:US
Mailing Address - Phone:601-376-2199
Mailing Address - Fax:601-376-2198
Practice Address - Street 1:1860 CHADWICK DR STE 205
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204-3466
Practice Address - Country:US
Practice Address - Phone:601-376-2199
Practice Address - Fax:601-376-2198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS10954207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS512G700458Medicare PIN