Provider Demographics
NPI:1568468007
Name:LOCASCIO, ALEXANDER (DO)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:LOCASCIO
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 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:210 W 53RD ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-2251
Practice Address - Country:US
Practice Address - Phone:563-386-6430
Practice Address - Fax:563-386-3211
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03481207Q00000X
IL036096869207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
217407OtherIOWA HEALTH SOLUTIONS
080442OtherHEALTH ALLIANCE
IL036096869Medicaid
IA01G9OtherJOHN DEERE HEALTH PLAN
IA0277558Medicaid
4796890009OtherDMERC
33361OtherWELLMARK BC/BS
IAI8609Medicare PIN
217407OtherIOWA HEALTH SOLUTIONS