Provider Demographics
NPI:1710923040
Name:VRABLE, ALEX J (DO)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:J
Last Name:VRABLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:ALEXANDER
Other - Middle Name:J
Other - Last Name:VRABLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:5900 YOUNGSTOWN POLAND RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44514
Mailing Address - Country:US
Mailing Address - Phone:330-757-0954
Mailing Address - Fax:330-757-1531
Practice Address - Street 1:5900 YOUNGSTOWN POLAND RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514
Practice Address - Country:US
Practice Address - Phone:330-757-0954
Practice Address - Fax:330-757-1531
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003726208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
8642096OtherCIGNA
OH0564849Medicaid
000000133964OtherANTHEM
8642096OtherCIGNA
A15766Medicare UPIN