Provider Demographics
NPI:1508743360
Name:ALEXANDER, LARRY JR
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:
Last Name:ALEXANDER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 MIDDLEBELT RD APT 107
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-2070
Mailing Address - Country:US
Mailing Address - Phone:313-878-1678
Mailing Address - Fax:
Practice Address - Street 1:3651 MIDDLEBELT RD APT 107
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-2070
Practice Address - Country:US
Practice Address - Phone:313-878-1678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker