Provider Demographics
NPI:1407548373
Name:DINGA, ALEXIS (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:DINGA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 PARLIAMENT LN
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2720
Mailing Address - Country:US
Mailing Address - Phone:205-966-4546
Mailing Address - Fax:
Practice Address - Street 1:3000 CAHABA VILLAGE PLZ STE 110
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35243-5954
Practice Address - Country:US
Practice Address - Phone:205-263-7836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2293363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant