Provider Demographics
NPI:1790771848
Name:DELA LLANA, ALEXANDER E (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:E
Last Name:DELA LLANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S ROSENBERGER AVE STE A200
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-6505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 S ROSENBERGER AVE STE A200
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-6505
Practice Address - Country:US
Practice Address - Phone:812-401-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059617A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200531250Medicaid
INI38231Medicare UPIN
IN237890OtherMEDICARE GROUP
INI38231Medicare UPIN
IN200531250Medicaid
IN237890EEMedicare PIN
IN250470QMedicare PIN
IN200829650GOtherMEDICAID GROUP
IN200859330FOtherMEDICAID GROUP
IN250470OtherMEDICARE GROUP
KY65945420OtherMEDICAID GROUP
INP00412978OtherRAILROAD INDIVIDUAL
INDF3251OtherRAILROAD GROUP
KY64105844Medicaid