Healthcare Provider Details

I. General information

NPI: 1053383711
Provider Name (Legal Business Name): ARLENE GAY KIRSCHNER M.D. APC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 03/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3419 AIRPORT WAY STE B
FAIRBANKS AK
99709-4761
US

IV. Provider business mailing address

PO BOX 72283
FAIRBANKS AK
99707-2283
US

V. Phone/Fax

Practice location:
  • Phone: 907-474-4745
  • Fax: 907-374-8715
Mailing address:
  • Phone: 907-474-4745
  • Fax: 907-374-8915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberAA2464
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: