Healthcare Provider Details

I. General information

NPI: 1518095264
Provider Name (Legal Business Name): DAVID POTASHNICK PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4374 LAURA MADISON ST.
BARROW AK
99723-0069
US

IV. Provider business mailing address

PO BOX 346
BARROW AK
99723-0346
US

V. Phone/Fax

Practice location:
  • Phone: 907-852-0307
  • Fax:
Mailing address:
  • Phone: 907-852-0307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number290
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number397
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: