Blake D. Alexander, Md, PA

NPI #1366626483 in Pocatello, Idaho

Provider Information

NPI Number: 1366626483
Entity Type: Organization
Organization Name: Blake D. Alexander, Md, PA
Primary Specialty: Dermatology
Enumeration Date: Dec 26, 2007
Last Updated: Dec 26, 2007

Practice Location

Address: 500 S 11TH AVE
Address 2: SUITE 203
City: Pocatello
State: Idaho
ZIP Code: 83201-4835
Phone: (208) 236-1600

Authorized Official

Name: BLAKE D. ALEXANDER, MD
Title: PRESIDENT
Phone: (208) 236-1600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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