Basic Information
| Provider Information | |||||||||
| NPI: | 1114260932 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRIDGES | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | WILLARD | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 540 NORTH DUKE STREET | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176022374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175444995 | ||||||||
| FaxNumber: | 7175444944 | ||||||||
| Practice Location | |||||||||
| Address1: | 540 NORTH DUKE STREET | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176022374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175444995 | ||||||||
| FaxNumber: | 7175444944 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2013 | ||||||||
| LastUpdateDate: | 01/06/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD473941 | PA | N | Allopathic & Osteopathic Physicians | Surgery | 208G00000X | MD473941 | PA | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.