Provider Demographics
NPI:1598309072
Name:WERNER, ALEXANDER JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:JOSEPH
Last Name:WERNER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NORTH BEST AVENUE
Mailing Address - Street 2:P.O. BOX #29
Mailing Address - City:WALNUTPORT
Mailing Address - State:PA
Mailing Address - Zip Code:18088-0029
Mailing Address - Country:US
Mailing Address - Phone:610-767-1555
Mailing Address - Fax:
Practice Address - Street 1:301 N BEST AVE
Practice Address - Street 2:
Practice Address - City:WALNUTPORT
Practice Address - State:PA
Practice Address - Zip Code:18088-1206
Practice Address - Country:US
Practice Address - Phone:610-767-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003623152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist