Provider Demographics
NPI:1114190824
Name:SURGERY ASSISTANTS OF ALASKA LLC
Entity Type:Organization
Organization Name:SURGERY ASSISTANTS OF ALASKA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAYNE
Authorized Official - Middle Name:T
Authorized Official - Last Name:CROWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-248-8561
Mailing Address - Street 1:9150 JEWEL LAKE ROAD STE B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502
Mailing Address - Country:US
Mailing Address - Phone:907-248-8561
Mailing Address - Fax:907-248-8563
Practice Address - Street 1:9150 JEWEL LAKE ROAD STE B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502
Practice Address - Country:US
Practice Address - Phone:907-248-8561
Practice Address - Fax:907-248-8563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3449261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care