Provider Demographics
NPI:1174542807
Name:ALEXANDER, JAMES R JR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:ALEXANDER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2508 BERT KOUNS INDUSTRIAL LOOP
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-3133
Mailing Address - Country:US
Mailing Address - Phone:318-688-1204
Mailing Address - Fax:318-688-8944
Practice Address - Street 1:2508 BERT KOUNS INDUSTRIAL LOOP
Practice Address - Street 2:SUITE 105
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-3133
Practice Address - Country:US
Practice Address - Phone:318-688-1204
Practice Address - Fax:318-688-8944
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2016-12-30
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Provider Licenses
StateLicense IDTaxonomies
LAL015020207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1341649Medicaid
LAL0100Medicare PIN