Provider Demographics
NPI:1720154594
Name:ALEXANDER, DAVID LEE III (PA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEE
Last Name:ALEXANDER
Suffix:III
Gender:M
Credentials:PA
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Mailing Address - Street 1:95 COLLIER ROAD
Mailing Address - Street 2:SUITE 5015
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309
Mailing Address - Country:US
Mailing Address - Phone:404-605-2800
Mailing Address - Fax:404-351-5983
Practice Address - Street 1:95 COLLIER ROAD
Practice Address - Street 2:SUITE 5015
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:404-605-2800
Practice Address - Fax:404-351-5983
Is Sole Proprietor?:No
Enumeration Date:2006-11-25
Last Update Date:2011-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA004894363AM0700X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA370799192AMedicaid
GA20297I1148Medicare PIN