Healthcare Provider Details

I. General information

NPI: 1831296995
Provider Name (Legal Business Name): ALASKA HOSPITALIST GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 B STREET SUITE 200
ANCHORAGE AK
99503
US

IV. Provider business mailing address

4300 B STREET SUITE 200
ANCHORAGE AK
99503
US

V. Phone/Fax

Practice location:
  • Phone: 907-375-3355
  • Fax: 907-375-3351
Mailing address:
  • Phone: 907-375-3355
  • Fax: 907-375-3351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOCELYN PEMBERTON
Title or Position: CEO
Credential: MBA
Phone: 907-375-3355