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General NPI Number Information
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NPI Number | 1043345259
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Entity Type | Organization
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Legal Business Name | ANCHORAGE ONCOLOGY CENTRE,LLC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 4231 LAKE OTIS PKWY SUITE B2
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City | ANCHORAGE
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State | AK
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Zip | 99508-5214
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Country | US
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Telephone | 907-569-2627
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Fax | 907-569-2626
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Provider Business Mailing Address
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Address Line | 4231 LAKE OTIS PKWY SUITE B2
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City | ANCHORAGE
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State | AK
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Zip | 99508-5214
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Country | US
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Telephone | 907-569-2627
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Fax | 907-569-2626
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Authorized Official
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Title or Position | MEMBER
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Name | LATHA SUBRAMANIAN
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Credential | M.D.
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Telephone | 907-569-2627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | AA2285
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License Number State | AK
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