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ALASKA INTERNAL MEDICINE & PEDIATRICS LLC NPI 1366580912


NPI Profile

NPI: 1366580912
Provider Name: ALASKA INTERNAL MEDICINE & PEDIATRICS LLC
Classification:Specialist - 174400000X
Entity Type: Organization

CLIA Number: 02D0687680

Address:
4048 LAUREL ST STE 306
ANCHORAGE, AK
ZIP 99508
Get Directions

Phone: (907) 770-7800

ALASKA INTERNAL MEDICINE & PEDIATRICS LLC is a specialist in Anchorage, AK. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ALASKA INTERNAL MEDICINE & PEDIATRICS LLC NPI is 1366580912. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4048 LAUREL ST STE 306
ANCHORAGE, AK
ZIP 99508-391
Phone: (907) 770-7800
Fax: (907) 929-4660

The provider's authorized official is Michele L O'fallon .
The authorized official title is Owner and has the following contact phone number (907) 770-7800.

The CLIA number assigned to this NPI record is 02D0687680 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2007 and was last updated on 6/26/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistAA3566ALASKANo
2174400000XSpecialist2342ALASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G06741MEDICARE UPINALASKA
2MD2282MEDICAIDALASKA
3MD7864MEDICAIDALASKA
41710958061OTHERALASKAMONTANO (NPI)
5H63242MEDICARE UPINALASKA
6K152146MEDICARE ID-TYPE UNSPECIFIEDALASKAO'FALLON MD, MICHELE
7K152147MEDICARE ID-TYPE UNSPECIFIEDALASKAAK INTERNAL MEDICINE & PE
81902877251OTHERALASKAO'FALLON (NPI)
9K152174MEDICARE ID-TYPE UNSPECIFIEDALASKAMONTANO MD, LAURIE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/11/2021

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