Provider Demographics
NPI:1467440875
Name:FAMILY PRACTICE ASSOCIATES LLC
Entity Type:Organization
Organization Name:FAMILY PRACTICE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-646-8306
Mailing Address - Street 1:2841 DEBARR RD
Mailing Address - Street 2:STE 31
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2967
Mailing Address - Country:US
Mailing Address - Phone:907-264-2000
Mailing Address - Fax:907-222-3298
Practice Address - Street 1:2841 DEBARR RD
Practice Address - Street 2:STE 31
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2967
Practice Address - Country:US
Practice Address - Phone:907-264-2000
Practice Address - Fax:907-222-3298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty