Jack W Alexander, MD
Individual provider Active NPI Internal Medicine Physician · Red Wing, MN
NPI 1952376014 · NPPES record last updated Mar 21, 2014
Key facts
- NPI
- 1952376014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 27095 (MN)
- Practice address
- 701 Hewitt Blvd
Red Wing, MN 55066-2848 - Phone
- (651) 267-5000
- NPI assigned
- Feb 22, 2006
- 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)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 27095 | MN | Yes |
Addresses
Primary practice location
701 Hewitt Blvd
Red Wing, MN 55066-2848
Mailing address
701 Hewitt Blvd
Red Wing, MN 55066-2848
Phone (651) 267-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952376014 | Medicaid | MN |
Other providers in Red Wing, MN
- Matthew R Affeldt
- Kristin M Ahdunko
- Asani Ajogun
- Kanko Akakpovi
- Said Haider Al Tawil
- Holli Pauline Alladin
- Brittney Joy Amdahl
- Jaedyn Marie Anderson
- Tianna Shantae Anderson
- Aquatally
All providers in Red Wing, MN · Internal Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2014. 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.