Healthcare Provider Details

I. General information

NPI: 1982693586
Provider Name (Legal Business Name): JOSEPH VINCENT PACE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N MULDOON RD SBHS
ANCHORAGE AK
99504-6104
US

IV. Provider business mailing address

25850 DENAINA DR
EAGLE RIVER AK
99577-9103
US

V. Phone/Fax

Practice location:
  • Phone: 907-257-4841
  • Fax: 907-257-4842
Mailing address:
  • Phone: 907-257-4841
  • Fax: 907-257-6747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5913
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: