Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 10954 | MS |
NPI | 1073595989 |
---|---|
Provider Name | Lon F. Alexander |
First Address | Meridian, MS 39302-5183 |
Second Address | Meridian, MS 39301-4158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 14/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00118703 | (05) | MS |
009910255 | (05) | AL |
140008223 | RAILROAD MEDICARE (01) | |
730-09296 | BLUE CROSS OF AL (01) | |
D77234 | (02) |