Provider Demographics
NPI:1366914384
Name:ALEXANDER, WILLIAM ALAN
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ALAN
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 S 800 W
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-2400
Mailing Address - Country:US
Mailing Address - Phone:435-723-8548
Mailing Address - Fax:
Practice Address - Street 1:712 S 200 E
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-3387
Practice Address - Country:US
Practice Address - Phone:435-695-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker