Provider Demographics
NPI:1114094851
Name:ALEXANDER, JAMES O (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:O
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2101 N AMERICA RD
Mailing Address - Street 2:
Mailing Address - City:GALATIA
Mailing Address - State:IL
Mailing Address - Zip Code:62935
Mailing Address - Country:US
Mailing Address - Phone:618-992-3273
Mailing Address - Fax:618-992-3273
Practice Address - Street 1:1009 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1841
Practice Address - Country:US
Practice Address - Phone:618-992-3272
Practice Address - Fax:618-992-3273
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036081824208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036081824Medicaid
IL036081824Medicaid
ILD94691Medicare UPIN