| Coralyn J Alexander Md Pa | |
|
488 Blue Lakes Blvd N Ste 102 Twin Falls ID 83301-4800 | |
| (208) 734-3900 | |
| (208) 734-9441 |
| Full Name | Coralyn J Alexander Md Pa |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 488 Blue Lakes Blvd N, Twin Falls, Idaho |
| Authorized Official Name and Position | Coralyn Alexander (OWNER) |
| Authorized Official Contact | 2087343900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coralyn J Alexander Md Pa Po Box 2103 Twin Falls ID 83303-2103 Ph: (208) 734-3900 | Coralyn J Alexander Md Pa 488 Blue Lakes Blvd N Ste 102 Twin Falls ID 83301-4800 Ph: (208) 734-3900 |
| NPI Number | 1922282821 |
|---|---|
| Provider Enumeration Date | 12/27/2007 |
| Last Update Date | 08/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922282821 | NPI | - | NPPES |
| 804052700 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | NP662 (Idaho) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | M6940 (Idaho) | Primary |
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