Healthcare Provider Details

I. General information

NPI: 1003803214
Provider Name (Legal Business Name): ALASKA RADIOLOGY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 PIPER STREET SUITE A
ANCHORAGE AK
99508
US

IV. Provider business mailing address

3650 PIPER STREET SUITE A
ANCHORAGE AK
99508
US

V. Phone/Fax

Practice location:
  • Phone: 907-222-4624
  • Fax: 907-222-4651
Mailing address:
  • Phone: 907-222-4624
  • Fax: 907-222-4651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: SHARLEE LEBLEU
Title or Position: VICE PRESIDENT
Credential:
Phone: 480-321-7026