1902871411 NPI number — ALASKA OB/GYN CARE, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902871411 NPI number — ALASKA OB/GYN CARE, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALASKA OB/GYN CARE, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902871411
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 AIRPORT HEIGHTS DR
Provider Second Line Business Mailing Address:
SUITE #240
Provider Business Mailing Address City Name:
ANCHORAGE
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99508-2943
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-278-2070
Provider Business Mailing Address Fax Number:
907-278-2075

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 AIRPORT HEIGHTS DR
Provider Second Line Business Practice Location Address:
SUITE #240
Provider Business Practice Location Address City Name:
ANCHORAGE
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99508-2943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-278-2070
Provider Business Practice Location Address Fax Number:
907-278-2075
Provider Enumeration Date:
02/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCCLEAVE
Authorized Official First Name:
MELANIE
Authorized Official Middle Name:
KAE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
907-278-2070

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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