Provider Demographics
NPI:1144696808
Name:STARKEY, ALEXANDRA
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:STARKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 BYERS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3684
Mailing Address - Country:US
Mailing Address - Phone:937-865-0534
Mailing Address - Fax:937-865-0721
Practice Address - Street 1:415 BYERS RD STE 300
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3684
Practice Address - Country:US
Practice Address - Phone:937-865-0534
Practice Address - Fax:937-865-0721
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0142587Medicaid
OH0142587Medicaid