Provider Demographics
NPI:1275067399
Name:POLLARD-JOSEPH, SHARON
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:POLLARD-JOSEPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:LUCIA
Other - Last Name:POLLARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4434 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2223
Mailing Address - Country:US
Mailing Address - Phone:907-205-9695
Mailing Address - Fax:
Practice Address - Street 1:4434 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2223
Practice Address - Country:US
Practice Address - Phone:907-350-2304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101224305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization