Healthcare Provider Details

I. General information

NPI: 1710992581
Provider Name (Legal Business Name): ALLAN ALBERTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4951 BUSINESS PARK BLVD
ANCHORAGE AK
99503-7174
US

IV. Provider business mailing address

2200 S CREEKSHORE CIR
WASILLA AK
99623-0206
US

V. Phone/Fax

Practice location:
  • Phone: 907-743-7200
  • Fax:
Mailing address:
  • Phone: 907-743-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number67035
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME95825
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number100685
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: