Provider Demographics
NPI:1720168735
Name:ALEXANDER, CARRIE O'NEAL (MD)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:O'NEAL
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
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 12366
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202-2366
Mailing Address - Country:US
Mailing Address - Phone:205-206-8219
Mailing Address - Fax:205-206-8300
Practice Address - Street 1:832 PRINCETON AVE SW
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1320
Practice Address - Country:US
Practice Address - Phone:205-206-8450
Practice Address - Fax:205-206-8364
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC34206207R00000X
AL22390207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051558357Medicaid
AL510-04521OtherBLUE CROSS
H18420Medicare UPIN
AL510-04521OtherBLUE CROSS