Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | C19995 | |
N | 222Z00000X | Podiatrist | C19995 | |
Y | 224P00000X | Prosthetist | PRO0000000075 | TN |
NPI | 1144402389 |
---|---|
Provider Name | Christopher Wayne Alexander |
First Address | Kingsport, TN 37660-7115 |
Second Address | Kingsport, TN 37660-7115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2007 |
Last Update Date | 29/11/2007 |