Provider Demographics
NPI:1619330099
Name:ALEXANDER, JAMIE (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 SOUTH SAINT LEWIS AVENUE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120
Mailing Address - Country:US
Mailing Address - Phone:918-619-4400
Mailing Address - Fax:
Practice Address - Street 1:1111 S SAINT LOUIS AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-5440
Practice Address - Country:US
Practice Address - Phone:918-663-4400
Practice Address - Fax:918-619-4696
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2023-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6129207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200749710AMedicaid