Provider Demographics
NPI:1346406758
Name:BRIAN F. SWEENEY M.D., APC
Entity Type:Organization
Organization Name:BRIAN F. SWEENEY M.D., APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADELLA
Authorized Official - Middle Name:K
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
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:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKMD4461174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD4461Medicaid
AKMD4461Medicaid