Provider Demographics
NPI:1164899282
Name:ARCTIC BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:ARCTIC BEHAVIORAL HEALTH
Other - Org Name:HOWARD F. DETWILER JR. M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:DETWILER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:907-770-0585
Mailing Address - Street 1:4141 B ST STE 302
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-5942
Mailing Address - Country:US
Mailing Address - Phone:907-770-0585
Mailing Address - Fax:907-770-0586
Practice Address - Street 1:4141 B ST STE 302
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5942
Practice Address - Country:US
Practice Address - Phone:907-770-0585
Practice Address - Fax:907-770-0586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK28492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1632339Medicaid
AKE98808Medicare UPIN