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General NPI Number Information
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NPI Number | 1982047437
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Entity Type | Organization
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Legal Business Name | ALASKA TRAUMA & ACUTE CARE SURGERY, LLC
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Dates
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Enumeration Date | 04/15/2013
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 3220 PROVIDENCE DR STE E3-080
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City | ANCHORAGE
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State | AK
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Zip | 99508-4657
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Country | US
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Telephone | 907-375-8785
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Fax | 907-375-8788
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Provider Business Mailing Address
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Address Line | PO BOX 200667
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City | ANCHORAGE
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State | AK
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Zip | 99520-0667
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Country | US
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Telephone | 907-375-8785
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Fax | 907-375-8788
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CINDERELLA TOLLEFSEN
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Credential |
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Telephone | 907-375-8785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 984564
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License Number State | AK
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