Healthcare Provider Details

I. General information

NPI: 1295091239
Provider Name (Legal Business Name): REBECCA WEICHT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA RAE WEICHT

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 DIPLOMACY DR
ANCHORAGE AK
99508-5926
US

IV. Provider business mailing address

7033 E TUDOR RD
ANCHORAGE AK
99507-1262
US

V. Phone/Fax

Practice location:
  • Phone: 907-729-3300
  • Fax:
Mailing address:
  • Phone: 907-729-9989
  • Fax: 907-729-5180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number128595
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number5101021803
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number128595
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: