Healthcare Provider Details

I. General information

NPI: 1174702468
Provider Name (Legal Business Name): WOMEN'S CARE OF ALASKA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 11/01/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 DEBARR RD STE C205
ANCHORAGE AK
99508
US

IV. Provider business mailing address

2741 DEBARR RD STE C205
ANCHORAGE AK
99508-2961
US

V. Phone/Fax

Practice location:
  • Phone: 907-279-2273
  • Fax: 907-258-7705
Mailing address:
  • Phone: 907-279-2273
  • Fax: 907-258-7705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number403096
License Number StateAK

VIII. Authorized Official

Name: DR. WYND COUNTS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 907-279-2273