Provider Demographics
NPI:1356786974
Name:CORLEY, ALEXANDRA MYRICK SIMS (MD MPH)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:MYRICK SIMS
Last Name:CORLEY
Suffix:
Gender:F
Credentials:MD MPH
Other - Prefix:DR
Other - First Name:ALEXANDRA
Other - Middle Name:MYRICK
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3333 BURNET AVE.
Mailing Address - Street 2:MLC 7035
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229
Mailing Address - Country:US
Mailing Address - Phone:513-517-1253
Mailing Address - Fax:
Practice Address - Street 1:PEDIATRIC PRIMARY CARE CENTER
Practice Address - Street 2:3430 BURNET AVE MLC 5026
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-517-1253
Practice Address - Fax:513-636-3737
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD044118208000000X
OH35.139799208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics