Jean K Alexander, MD

Individual provider Active NPI Allergy & Immunology Physician · Dickson, TN

NPI 1790788982 · NPPES record last updated Feb 2, 2012

Key facts

NPI
1790788982
Entity type
Individual (NPI type 1)
Primary specialty
Allergy & Immunology Physician 207K00000X
License
MD15804 (TN)
Practice address
127 Crestview Park Dr
Dickson, TN 37055-2850
Phone
(615) 446-5121
Fax
(615) 446-1357
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD15804TNMDAllergy & Immunology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD15804 TN Yes

Addresses

Primary practice location

127 Crestview Park Dr
Dickson, TN 37055-2850

Mailing address

127 Crestview Park Dr
Dickson, TN 37055-2850
Phone (615) 446-5121

Other identifiers

IdentifierTypeStateIssuer
040015454OtherRAILROAD MEDICARE
3816880MedicaidTN
3158419OtherTNBLUE CROSS BLUE SHIELD TN
3158421OtherTNBLUE CROSS BLUE SHIELD TN

Other providers in Dickson, TN

All providers in Dickson, TN · Allergy & Immunology Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.