Provider Demographics
NPI:1366883316
Name:ALEXIS, BRIAN ANDREW (DO)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ANDREW
Last Name:ALEXIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 S ROSENBERGER AVE STE B200
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-6504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 S ROSENBERGER AVE STE B200
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-6504
Practice Address - Country:US
Practice Address - Phone:812-433-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-07
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03909207Q00000X
IN02006777A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine