Provider Demographics
NPI:1326255217
Name:POLLOCK, RONALD K (DO)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:K
Last Name:POLLOCK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2550 DENALI ST
Mailing Address - Street 2:SUITE 1597
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2783
Mailing Address - Country:US
Mailing Address - Phone:907-272-1892
Mailing Address - Fax:907-272-0962
Practice Address - Street 1:2550 DENALI ST
Practice Address - Street 2:SUITE 1597
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2783
Practice Address - Country:US
Practice Address - Phone:907-272-1892
Practice Address - Fax:907-272-0962
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2008-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK22972084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD0229Medicaid
AKMD0229Medicaid
0000LGBQDMedicare PIN