Provider Demographics
NPI:1043474182
Name:ROBERT LADA MD LLC
Entity Type:Organization
Organization Name:ROBERT LADA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:LADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-261-3650
Mailing Address - Street 1:PO BOX 110977
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99511-0977
Mailing Address - Country:US
Mailing Address - Phone:907-261-3650
Mailing Address - Fax:866-684-2209
Practice Address - Street 1:3200 PROVIDENCE DR
Practice Address - Street 2:SUITE 248
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4615
Practice Address - Country:US
Practice Address - Phone:907-261-3650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty