Provider Demographics
NPI:1902020142
Name:ALEXANDER, ANTHONY R (LMT)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:R
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:KILLEN
Mailing Address - State:AL
Mailing Address - Zip Code:35645-0284
Mailing Address - Country:US
Mailing Address - Phone:256-656-0686
Mailing Address - Fax:
Practice Address - Street 1:220 RHETT AVE SW
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4552
Practice Address - Country:US
Practice Address - Phone:256-656-0686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL115174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist