Provider Demographics
NPI:1508901687
Name:ALEXANDER, F WAYNE (DC)
Entity Type:Individual
Prefix:
First Name:F
Middle Name:WAYNE
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N HARPER RD
Mailing Address - Street 2:STE 2
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834
Mailing Address - Country:US
Mailing Address - Phone:662-286-8868
Mailing Address - Fax:662-286-3646
Practice Address - Street 1:1500 N HARPER RD
Practice Address - Street 2:STE 2
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834
Practice Address - Country:US
Practice Address - Phone:662-286-8868
Practice Address - Fax:662-286-3646
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS15111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS350816700Medicare ID - Type UnspecifiedMEDICARE