Healthcare Provider Details

I. General information

NPI: 1689915373
Provider Name (Legal Business Name): ARLENE KIRSCHNER, M.D., APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2013
Last Update Date: 03/06/2013
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: 907-374-8915
Mailing address:
  • Phone: 907-474-4745
  • Fax: 888-840-9676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ARLENE G KIRSCHNER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 907-474-4745