Provider Demographics
NPI:1962553545
Name:THOMAS, ALEXANDER RANDOLPH
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:RANDOLPH
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:LEX
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:365 IVY VISTA DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-7434
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 COMMERCE RD
Practice Address - Street 2:SUITE 421
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-4446
Practice Address - Country:US
Practice Address - Phone:540-885-8143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241076208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics