Glenn Alexander
Individual provider Active NPI Physician Assistant · Fort Campbell, KY
NPI 1194861047 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1194861047
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1034819 (NE)
- Practice address
- Blanchfield Army Community Hospital
650 Joel Drive
Fort Campbell, KY 42223-5349 - Phone
- (270) 798-8727
- Fax
- (270) 956-0180
- NPI assigned
- Jan 29, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1034819 | NE | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1034819 | NE | Yes |
Addresses
Primary practice location
Blanchfield Army Community Hospital
650 Joel Drive
Fort Campbell, KY 42223-5349
Mailing address
Blanchfield Army Community Hospital
650 Joel Drive
Fort Campbell, KY 42223-5349
Phone (270) 798-8727
Other providers in Fort Campbell, KY
- Matthew Ahola
- Yvette Marie Albright
- James Edmund Albritton Jr.
- Randall Dean Aldrich
- Richard C Ales
- Affi Allado-Anka
- Desiree Allen
- Linda Allen
- Michele Allen
- Taylor Joseph Allen
All providers in Fort Campbell, KY · Physician Assistant in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.