Healthcare Provider Details

I. General information

NPI: 1730332594
Provider Name (Legal Business Name): ELIZABETH JANE FONTANA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W NORTHERN LIGHTS BLVD STE 400
ANCHORAGE AK
99503-2648
US

IV. Provider business mailing address

301 W NORTHERN LIGHTS BLVD STE 400
ANCHORAGE AK
99503-2648
US

V. Phone/Fax

Practice location:
  • Phone: 907-563-4810
  • Fax: 907-563-4811
Mailing address:
  • Phone: 907-563-4810
  • Fax: 907-563-4811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number249628
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: