Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 35126041 | OH |
NPI | 1003043902 |
---|---|
Provider Name | Dr. Alexander A Farag |
First Address | Orange Park, FL 32073-4592 |
Second Address | Columbus, OH 43212-3153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 18/10/2021 |