Provider Demographics
NPI:1497994859
Name:ALASKA ORTHOPEDIC SPECIALISTS, LLC
Entity Type:Organization
Organization Name:ALASKA ORTHOPEDIC SPECIALISTS, LLC
Other - Org Name:MICHAEL G MCNAMARA MD LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-771-3500
Mailing Address - Street 1:4015 LAKE OTIS PKWY
Mailing Address - Street 2:STE 201
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-771-3500
Mailing Address - Fax:907-771-3550
Practice Address - Street 1:4015 LAKE OTIS PKWY
Practice Address - Street 2:STE 201
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-771-3500
Practice Address - Fax:907-771-3550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK905217207XS0106X
207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1020523Medicaid