Provider Demographics
NPI:1174500045
Name:BRIAN F SWEENEY JR M D APC
Entity Type:Organization
Organization Name:BRIAN F SWEENEY JR M D APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:M D
Authorized Official - Phone:907-562-2928
Mailing Address - Street 1:4048 LAUREL ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5389
Mailing Address - Country:US
Mailing Address - Phone:907-562-2928
Mailing Address - Fax:907-563-4848
Practice Address - Street 1:4048 LAUREL ST
Practice Address - Street 2:SUITE 301
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5389
Practice Address - Country:US
Practice Address - Phone:907-562-2928
Practice Address - Fax:907-563-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5662207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD5662Medicaid
AKMD5662Medicaid
152695Medicare ID - Type Unspecified