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General NPI Number Information
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NPI Number | 1114548351
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Entity Type | Organization
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Legal Business Name | ALASKA FACIAL PLASTIC SURGERY & ENT
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Dates
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Enumeration Date | 04/28/2020
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 3719 E MERIDIAN LOOP STE E
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City | WASILLA
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State | AK
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Zip | 99654-7273
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Country | US
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Telephone | 907-522-3006
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 75045
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City | CHICAGO
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State | IL
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Zip | 60675-5045
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Country | US
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Telephone | 907-600-0030
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Fax | 907-206-7153
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTINA MAGILL
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Credential | MD
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Telephone | 314-422-9716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number |
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License Number State |
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