Provider Demographics
NPI:1891873618
Name:ALEXANDER, STEVEN M (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:ALEXANDER
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 1:768 S WILLOW AVE STE A
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3892
Mailing Address - Country:US
Mailing Address - Phone:931-559-6900
Mailing Address - Fax:931-548-6909
Practice Address - Street 1:768 S WILLOW AVE STE A
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3892
Practice Address - Country:US
Practice Address - Phone:931-559-6900
Practice Address - Fax:931-548-6909
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30848207Q00000X
CAA82314208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A823140Medicaid
H44543Medicare UPIN
CA00A823140Medicaid