Provider Demographics
NPI:1679888994
Name:ALEXANDER, VICTORIA R (DO)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:R
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:R
Other - Last Name:OHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:231 SEASONS RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44224
Mailing Address - Country:US
Mailing Address - Phone:330-662-5666
Mailing Address - Fax:330-655-3845
Practice Address - Street 1:231 SEASONS RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44224
Practice Address - Country:US
Practice Address - Phone:330-662-5666
Practice Address - Fax:330-655-3845
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34010760207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0091226Medicaid
H190300Medicare PIN