Provider Demographics
NPI:1487861423
Name:ALEXANDER, KENNETH SAUL (PHD)
Entity Type:Individual
Prefix:PROF
First Name:KENNETH
Middle Name:SAUL
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7924 WISEMAN RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9682
Mailing Address - Country:US
Mailing Address - Phone:734-856-5840
Mailing Address - Fax:734-856-5840
Practice Address - Street 1:7924 WISEMAN RD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-9682
Practice Address - Country:US
Practice Address - Phone:734-856-5840
Practice Address - Fax:734-856-5840
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-10590183500000X
PARP025303L183500000X
MI5302025906183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist