Provider Demographics
NPI:1194804468
Name:MACY, ALEXANDER W (DC)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:W
Last Name:MACY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 929
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:IA
Mailing Address - Zip Code:50170-0929
Mailing Address - Country:US
Mailing Address - Phone:641-521-2828
Mailing Address - Fax:866-362-9047
Practice Address - Street 1:410 N YORK ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:IA
Practice Address - Zip Code:50170-7798
Practice Address - Country:US
Practice Address - Phone:641-521-2828
Practice Address - Fax:866-362-9047
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04750111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0174177Medicaid
IA01735Medicare PIN