Provider Demographics
NPI:1386027621
Name:FALK, ALEXANDER S (PA)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:S
Last Name:FALK
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:2400 UNSER BLVD SE
Mailing Address - Street 2:STE 18200
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-4740
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5141 W BROAD ST
Practice Address - Street 2:SUITE 180
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1992
Practice Address - Country:US
Practice Address - Phone:614-544-1460
Practice Address - Fax:614-544-1853
Is Sole Proprietor?:No
Enumeration Date:2015-07-06
Last Update Date:2020-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMPA2020-0093363A00000X
OH50.004413363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant