Provider Demographics
NPI:1376506683
Name:ALEXANDER, SCOTT F (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:F
Last Name:ALEXANDER
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:PO BOX 36680
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85067-6680
Mailing Address - Country:US
Mailing Address - Phone:602-285-9550
Mailing Address - Fax:602-234-3748
Practice Address - Street 1:222 W THOMAS RD
Practice Address - Street 2:STE 102
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4419
Practice Address - Country:US
Practice Address - Phone:602-285-9550
Practice Address - Fax:602-234-3748
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-08
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16316208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAXPY091750OtherMEDI-CAL OF CALIFORNIA
AZAZ0251300OtherBLUE CROSS BLUE SHIELD
AZAZ6453OtherHEALTHNET OF AZ
AZ264309Medicaid
AZ264309Medicaid