Provider Demographics
NPI:1407000755
Name:DUCHANIN, JAMES N (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:N
Last Name:DUCHANIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 LAKESHORE DR.
Mailing Address - Street 2:BLDG A, STE 101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517
Mailing Address - Country:US
Mailing Address - Phone:907-426-9265
Mailing Address - Fax:907-426-8366
Practice Address - Street 1:3105 LAKESHORE DR.
Practice Address - Street 2:BLDG A, STE 101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517
Practice Address - Country:US
Practice Address - Phone:907-426-9265
Practice Address - Fax:907-426-8366
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK200363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant