Healthcare Provider Details

I. General information

NPI: 1578550067
Provider Name (Legal Business Name): CAROL MITCHELL SPRINGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 10/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4115 LAKE OTIS PARKWAY
ANCHORAGE AK
99508
US

IV. Provider business mailing address

3260 PROVIDENCE DR STE 322
ANCHORAGE AK
99508-4608
US

V. Phone/Fax

Practice location:
  • Phone: 907-563-7228
  • Fax: 907-563-6278
Mailing address:
  • Phone: 907-563-7228
  • Fax: 907-563-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number3220
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number3220
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number3220
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: