Healthcare Provider Details
I. General information
NPI: 1891735346
Provider Name (Legal Business Name): JUNE M GEORGE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/06/2006
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2751 DEBARR RD SUITE 280
ANCHORAGE AK
99508-2953
US
IV. Provider business mailing address
2751 DEBARR RD SUITE 280
ANCHORAGE AK
99508-2953
US
V. Phone/Fax
- Phone: 907-222-1401
- Fax: 907-222-1402
- Phone: 907-222-1401
- Fax: 907-222-1402
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 4148 |
| License Number State | AK |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | 4148 |
| License Number State | AK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: