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ALASKA PEDIATRIC SURGERY LLC NPI 1396140950


NPI Profile

NPI: 1396140950
Provider Name: ALASKA PEDIATRIC SURGERY LLC
Classification:Specialist - 174400000X
Entity Type: Organization
Address:
4100 LAKE OTIS PKWY
SUITE 206
ANCHORAGE, AK
ZIP 99508
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Phone: (907) 929-7337

ALASKA PEDIATRIC SURGERY 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 PEDIATRIC SURGERY LLC NPI is 1396140950. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4100 LAKE OTIS PKWY
SUITE 206
ANCHORAGE, AK
ZIP 99508-229
Phone: (907) 929-7337
Fax: (907) 929-7330

The provider's authorized official is Jeffrey Brent Roaten .
The authorized official title is President and has the following contact phone number (907) 717-9871.

The enumeration date for this NPI number is 10/24/2014 and was last updated on 10/24/2014.


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
1174400000XSpecialistYes

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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