Provider Demographics
NPI:1366931867
Name:KINGSBURY, ALEXANDER RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:RICHARD
Last Name:KINGSBURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 SHELBYVILLE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2992
Mailing Address - Country:US
Mailing Address - Phone:800-999-1249
Mailing Address - Fax:855-656-7325
Practice Address - Street 1:7927 JESSIES WAY
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-8077
Practice Address - Country:US
Practice Address - Phone:513-894-0500
Practice Address - Fax:855-656-7325
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY59621207K00000X
OH35.150565207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology