Provider Demographics
NPI:1912323700
Name:DONALD W ALEXANDER, MD PC
Entity Type:Organization
Organization Name:DONALD W ALEXANDER, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-424-7968
Mailing Address - Street 1:833 CAMPBELL HILL ST NW
Mailing Address - Street 2:SUITE 420
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1134
Mailing Address - Country:US
Mailing Address - Phone:770-424-1968
Mailing Address - Fax:770-424-4782
Practice Address - Street 1:833 CAMPBELL HILL ST NW
Practice Address - Street 2:SUITE 420
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1134
Practice Address - Country:US
Practice Address - Phone:770-424-1968
Practice Address - Fax:770-424-4782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA21471207Y00000X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000197986OMedicaid
GA000197986PMedicaid
GA000197986OMedicaid
GA000197986PMedicaid