Provider Demographics
NPI:1417138975
Name:ALEXANDER PROSTHETICS & ORTHOTICS INC
Entity Type:Organization
Organization Name:ALEXANDER PROSTHETICS & ORTHOTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CO, BOCO, CPED
Authorized Official - Phone:423-288-8599
Mailing Address - Street 1:1604 LAMONS LN
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-8224
Mailing Address - Country:US
Mailing Address - Phone:423-283-9744
Mailing Address - Fax:423-283-9744
Practice Address - Street 1:1604 LAMONS LN
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-8224
Practice Address - Country:US
Practice Address - Phone:423-283-9744
Practice Address - Fax:423-283-9744
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALEXANDER PROSTHETICS & ORTHOTICS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-26
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN702010907OtherCARITEN HEALTH CARE
TN1452533Medicaid
TNTN0103OtherUNITED HEALTH CARE
TNTN0103OtherUNITED HEALTH CARE