Provider Demographics
NPI:1225360233
Name:ROLAND E. GOWER, MD, APC
Entity Type:Organization
Organization Name:ROLAND E. GOWER, MD, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-279-3564
Mailing Address - Street 1:2841 DEBARR ROAD
Mailing Address - Street 2:SUITE #41
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2967
Mailing Address - Country:US
Mailing Address - Phone:907-279-3564
Mailing Address - Fax:907-279-8600
Practice Address - Street 1:2841 DEBARR ROAD
Practice Address - Street 2:SUITE #41
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2967
Practice Address - Country:US
Practice Address - Phone:907-279-3564
Practice Address - Fax:907-279-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1310208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD1310Medicaid
AKK0000WCGTZMedicare PIN
AKMD1310Medicaid