Provider Demographics
NPI:1417155987
Name:ADVANCED SONOGRAMS OF ALASKA, INC.
Entity Type:Organization
Organization Name:ADVANCED SONOGRAMS OF ALASKA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:F
Authorized Official - Last Name:PICKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-562-3111
Mailing Address - Street 1:PO BOX 142502
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99514-2502
Mailing Address - Country:US
Mailing Address - Phone:907-562-3111
Mailing Address - Fax:907-562-3136
Practice Address - Street 1:4200 LAKE OTIS PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5215
Practice Address - Country:US
Practice Address - Phone:907-562-3111
Practice Address - Fax:907-562-3136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Single Specialty