Provider Demographics
NPI:1831922459
Name:HADAWAY, ALEX JAY
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:JAY
Last Name:HADAWAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36854-3448
Mailing Address - Country:US
Mailing Address - Phone:334-756-2037
Mailing Address - Fax:334-756-9024
Practice Address - Street 1:4103 20TH AVE
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:AL
Practice Address - Zip Code:36854-3448
Practice Address - Country:US
Practice Address - Phone:334-756-2037
Practice Address - Fax:334-756-9024
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 172V00000X, 174H00000X
ALT53000183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No171400000XOther Service ProvidersHealth & Wellness Coach
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator