Provider Demographics
NPI:1497101919
Name:STALLER, ALEXANDER RICHARD (DO)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:RICHARD
Last Name:STALLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7261 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2311
Mailing Address - Country:US
Mailing Address - Phone:402-398-6248
Mailing Address - Fax:402-717-6014
Practice Address - Street 1:7710 MERCY RD STE 3000
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2350
Practice Address - Country:US
Practice Address - Phone:402-717-9600
Practice Address - Fax:402-717-6014
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS2907207R00000X
NE2611207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine