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General NPI Number Information
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NPI Number | 1205157286
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Entity Type | Organization
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Legal Business Name | NORTHERN VOICE AND LARYNGOLOGY, INC.
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 06/14/2010
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Provider Practice Location Address
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Address Line | 3195 CRAFT AVE
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City | FAIRBANKS
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State | AK
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Zip | 99709-5773
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Country | US
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Telephone | 907-474-4704
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Fax |
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Provider Business Mailing Address
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Address Line | 3195 CRAFT AVE
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City | FAIRBANKS
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State | AK
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Zip | 99709-5773
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Country | US
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Telephone | 907-474-4704
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS HAMMOND
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Credential | M.D.
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Telephone | 907-474-4704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 5623
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License Number State | AK
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