Healthcare Provider Details

I. General information

NPI: 1285677054
Provider Name (Legal Business Name): ANCHORAGE FRACTURE AND ORTHOPAEDIC CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 LAKE OTIS PKWY STE 220
ANCHORAGE AK
99508-5230
US

IV. Provider business mailing address

4100 LAKE OTIS PKWY STE 220
ANCHORAGE AK
99508-5230
US

V. Phone/Fax

Practice location:
  • Phone: 907-563-3145
  • Fax: 907-561-3967
Mailing address:
  • Phone: 907-563-3145
  • Fax: 833-464-5196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number433722
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number433722
License Number StateAK

VIII. Authorized Official

Name: TAMI MORRILL
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 907-261-7111