Basic Information
| Provider Information | |||||||||
| NPI: | 1922094846 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALEXANDER | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 S UNIVERSITY AVE | ||||||||
| Address2: | SUITE 505 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722055307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016644532 | ||||||||
| FaxNumber: | 5016634335 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 S UNIVERSITY AVE | ||||||||
| Address2: | SUITE 505 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722055307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016644532 | ||||||||
| FaxNumber: | 5016634335 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2005 | ||||||||
| LastUpdateDate: | 12/04/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | C-6718 | AR | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | C-6718 | AR | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 050019620 | 01 | AR | RAILROAD MEDICARE LRPM | OTHER | S00841 | 01 | AR | NOVASYS | OTHER | 113861001 | 05 | AR | MEDICAID | 14631000020 | 01 | AR | QUAL CHOICE PAIN | OTHER | 55634 | 01 | AR | BLUE CROSS BLUE SHIELD | OTHER | 770133301 | 01 | AR | ARKANSAS BREASTCARE | OTHER | 050019623 | 01 | AR | RAILROAD MEDICARE | OTHER | 171973300 | 01 | AR | US DEPT. OF LABOR OWCP | OTHER | 71033532430 | 01 | AR | QUAL CHOICE | OTHER |