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General NPI Number Information
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NPI Number | 1134073331
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Entity Type | Organization
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Legal Business Name | KBS MEDICAL ALASKA, P.C.
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Dates
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Enumeration Date | 02/24/2026
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 821 N ST STE 102
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City | ANCHORAGE
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State | AK
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Zip | 99501-3285
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Country | US
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Telephone | 909-679-3482
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Fax | 844-440-2410
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Provider Business Mailing Address
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Address Line | 169 MADISON AVE STE 15824
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City | NEW YORK
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State | NY
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Zip | 10016-5101
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Country | US
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Telephone | 909-679-3482
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Fax | 844-440-2410
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Authorized Official
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Title or Position | COO
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Name | LISA KENNEDY
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Credential |
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Telephone | 909-679-3482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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