Provider Demographics
NPI:1104810423
Name:ALEXANDER, CATHERINE HUGGINS (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:HUGGINS
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:CATHERINE
Other - Last Name:HUGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1805 PARKE PLAZA CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3498
Mailing Address - Country:US
Mailing Address - Phone:770-469-7000
Mailing Address - Fax:770-879-0436
Practice Address - Street 1:1805 PARKE PLAZA CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3498
Practice Address - Country:US
Practice Address - Phone:770-469-7000
Practice Address - Fax:770-879-0436
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA023611207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0528884OtherAETNA
GA080059350OtherRAILROAD MEDICARE
GA151303OtherBLUE CROSS BLUE SHIELD
GA00247035A1Medicaid
GA202I083368Medicare PIN
GA080059350OtherRAILROAD MEDICARE