Provider Demographics
NPI:1295949337
Name:BACHRACH, ALEXIS G (DO)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:G
Last Name:BACHRACH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ALEXIS
Other - Middle Name:G
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:410 N COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-1004
Mailing Address - Country:US
Mailing Address - Phone:440-537-3449
Mailing Address - Fax:
Practice Address - Street 1:400 MATTHEW ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1644
Practice Address - Country:US
Practice Address - Phone:740-373-4111
Practice Address - Fax:740-373-4860
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102202451207V00000X
OH34.009210207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4240111Medicare PIN