Provider Demographics
NPI:1316905409
Name:ALEX, NADINE HELEN (MD)
Entity type:Individual
Prefix:DR
First Name:NADINE
Middle Name:HELEN
Last Name:ALEX
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:593 HORSEBARN RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8795
Mailing Address - Country:US
Mailing Address - Phone:479-845-4707
Mailing Address - Fax:479-845-4708
Practice Address - Street 1:593 HORSEBARN RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8795
Practice Address - Country:US
Practice Address - Phone:479-845-4707
Practice Address - Fax:479-845-4708
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE4690207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR158983001Medicaid
5N427OtherMEDICARE PTAN
ARG59380Medicare UPIN