Basic Information
| Provider Information | |||||||||
| NPI: | 1043389331 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALEXANDRIA ASSOCIATES IN DERMATOLOGY, PC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ASSOCIATES IN DERMATOLOGY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 N. BEAUREGARD STREET | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | ALEXANDRIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032127546 | ||||||||
| FaxNumber: | 7032127282 | ||||||||
| Practice Location | |||||||||
| Address1: | 1900 N. BEAUREGARD STREET | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | ALEXANDRIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032127546 | ||||||||
| FaxNumber: | 7032127282 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2006 | ||||||||
| LastUpdateDate: | 05/07/2021 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SIMPSON | ||||||||
| AuthorizedOfficialFirstName: | JOANNE | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7032127546 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 05/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | N | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist | 207N00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.