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General NPI Number Information
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NPI Number | 1033305875
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICINE OF ALASKA INC
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 09/17/2007
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Provider Practice Location Address
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Address Line | 1261 S SEWARD MERIDIAN PKWY SUITE A
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City | WASILLA
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State | AK
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Zip | 99654-8334
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Country | US
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Telephone | 907-376-1276
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Fax | 907-373-0755
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Provider Business Mailing Address
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Address Line | 1261 S SEWARD MERIDIAN PKWY SUITE A
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City | WASILLA
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State | AK
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Zip | 99654-8334
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Country | US
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Telephone | 907-376-1276
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Fax | 907-373-0755
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. PATRICIA J LAJCSAK
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Credential |
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Telephone | 907-376-1276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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