Provider Demographics
NPI:1336145770
Name:ALEXANDER, RICHMOND L III (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHMOND
Middle Name:L
Last Name:ALEXANDER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 15TH ST
Mailing Address - Street 2:FL 2
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-4130
Mailing Address - Country:US
Mailing Address - Phone:601-553-2000
Mailing Address - Fax:601-483-9471
Practice Address - Street 1:2024 15TH ST
Practice Address - Street 2:FL 2
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-4130
Practice Address - Country:US
Practice Address - Phone:601-553-2000
Practice Address - Fax:601-483-9471
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS09065207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00123692Medicaid
MS290000160Medicare PIN
MS1110400001Medicare NSC
MS110029243Medicare PIN
MS00123692Medicaid