Healthcare Provider Details

I. General information

NPI: 1174716104
Provider Name (Legal Business Name): ALASKA WOMEN'S ADVANCED PELVIC SURGERY & UROGYNECOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 DEBARR RD SUITE 340
ANCHORAGE AK
99508-2953
US

IV. Provider business mailing address

2751 DEBARR RD STE B340
ANCHORAGE AK
99508-6806
US

V. Phone/Fax

Practice location:
  • Phone: 907-306-1222
  • Fax:
Mailing address:
  • Phone: 907-743-8064
  • Fax: 907-743-8065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ROGER CORY BIEHL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 907-306-1222