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NPI Code Detail

MEDICARE: DR. PATTIE TANG O.D.

MEDICARE: DR. PATTIE TANG O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist223AK

General Provider Information

NPI Number : 1942348289
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATTIE TANG O.D.
Provider Business Mailing Address
First Line : PO BOX 110718
Second Line :
City : ANCHORAGE
State : AK
Zip : 99511-0718
Country : US
Telephone Number : 907-569-2030
Fax Number :
Provider Business Practice Location Address
First Line : 8900 OLD SEWARD HWY
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-2022
Country : US
Telephone Number : 907-569-2030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2007
Last Update Date : 09/03/2007

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Directions to “ DR. PATTIE TANG O.D.” Practice Location

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