Provider Demographics
NPI:1427707397
Name:KNUDSON, ALEXANDER MADSEN (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:MADSEN
Last Name:KNUDSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:458 N 750 E
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-2814
Mailing Address - Country:US
Mailing Address - Phone:801-698-2636
Mailing Address - Fax:
Practice Address - Street 1:458 N 750 E
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-2814
Practice Address - Country:US
Practice Address - Phone:801-698-2636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-19
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program