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General NPI Number Information
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NPI Number | 1467528042
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Entity Type | Individual
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Provider Name | MARY CORDNER MACFARLANE M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1919 LATHROP ST SUITE 100
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City | FAIRBANKS
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State | AK
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Zip | 99701-5930
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Country | US
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Telephone | 907-452-1761
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Fax | 907-451-3321
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Provider Business Mailing Address
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Address Line | 1103 WILLOW GROUSE RD
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City | FAIRBANKS
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State | AK
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Zip | 99712-1247
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Country | US
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Telephone | 907-457-3738
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | AA1161
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License Number State | AK
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