Provider Demographics
NPI:1194081422
Name:FORD, ALEXCIS THOMSON (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXCIS
Middle Name:THOMSON
Last Name:FORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1561 JANMAR RD
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-5639
Mailing Address - Country:US
Mailing Address - Phone:678-344-8900
Mailing Address - Fax:678-666-5201
Practice Address - Street 1:11660 ALPHARETTA HWY STE 710
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4916
Practice Address - Country:US
Practice Address - Phone:678-344-8900
Practice Address - Fax:678-666-5201
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA076588207V00000X, 207VF0040X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program