Provider Demographics
NPI:1922296359
Name:ALEX ENDOCRINE ASSOCIATES, PA
Entity Type:Organization
Organization Name:ALEX ENDOCRINE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:ALEX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-845-4707
Mailing Address - Street 1:593 HORSEBARN RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8795
Mailing Address - Country:US
Mailing Address - Phone:479-845-4707
Mailing Address - Fax:479-845-4708
Practice Address - Street 1:593 HORSEBARN RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8795
Practice Address - Country:US
Practice Address - Phone:479-845-4707
Practice Address - Fax:479-845-4708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4690207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5F894OtherPTAN