Healthcare Provider Details

I. General information

NPI: 1013466796
Provider Name (Legal Business Name): SCOTT GABRESKI O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 SADLER WAY
FAIRBANKS AK
99701-3175
US

IV. Provider business mailing address

1275 SADLER WAY STE 103
FAIRBANKS AK
99701-3175
US

V. Phone/Fax

Practice location:
  • Phone: 907-888-8174
  • Fax:
Mailing address:
  • Phone: 907-888-8174
  • Fax: 855-729-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number223575
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: