Healthcare Provider Details

I. General information

NPI: 1265795983
Provider Name (Legal Business Name): URBAN ANESTHESIOLOGY, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2012
Last Update Date: 03/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 LAUREL ST SUITE 202
ANCHORAGE AK
99508-5300
US

IV. Provider business mailing address

4001 LAUREL ST SUITE 202
ANCHORAGE AK
99508-5300
US

V. Phone/Fax

Practice location:
  • Phone: 907-277-7246
  • Fax:
Mailing address:
  • Phone: 907-277-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number5298
License Number StateAK

VIII. Authorized Official

Name: DR. JANN L. URBAN
Title or Position: PRESIDENT
Credential: MD
Phone: 907-277-7246