Provider Demographics
NPI:1427152800
Name:ALEXANDER, KEITH J (MD)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:J
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1720 NICHOLASVILLE ROAD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503
Mailing Address - Country:US
Mailing Address - Phone:859-278-1114
Mailing Address - Fax:859-277-0541
Practice Address - Street 1:1720 NICHOLASVILLE ROAD
Practice Address - Street 2:SUITE 500
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503
Practice Address - Country:US
Practice Address - Phone:859-278-1114
Practice Address - Fax:859-277-0541
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KYKY26368207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64263684Medicaid
KYK066520Medicare PIN
KY0383902Medicare PIN
E07410Medicare UPIN
KY64263684Medicaid
KY0169Medicare PIN