Provider Demographics
NPI:1073689717
Name:BLOWER, VICTORIA ANN (OD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANN
Last Name:BLOWER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MS
Other - First Name:VICTORIA
Other - Middle Name:ANN
Other - Last Name:BLOWER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:207 E NORTHERN LIGHTS
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2730
Mailing Address - Country:US
Mailing Address - Phone:907-272-9800
Mailing Address - Fax:907-277-1398
Practice Address - Street 1:207 E NORTHERN LIGHTS BLVD
Practice Address - Street 2:STE 101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2730
Practice Address - Country:US
Practice Address - Phone:907-272-9800
Practice Address - Fax:907-277-1398
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK118152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK0D0118Medicaid
AKK0000PHGPPMedicare PIN
AKU13615Medicare UPIN
AK0D0118Medicaid
AK0000PHGPPMedicare ID - Type Unspecified