Provider Demographics
NPI:1518266410
Name:GAMBLE, ALEXANDER JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:JAMES
Last Name:GAMBLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6983
Mailing Address - Country:US
Mailing Address - Phone:603-472-8888
Mailing Address - Fax:603-472-9090
Practice Address - Street 1:4 HAWTHORNE DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6983
Practice Address - Country:US
Practice Address - Phone:034-728-8886
Practice Address - Fax:603-472-9090
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NH18960207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3113060Medicaid