Provider Demographics
NPI:1568579886
Name:DEKEYSER, JOHN BAPTIST (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BAPTIST
Last Name:DEKEYSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1200 AIRPORT HEIGHTS DRIVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2943
Mailing Address - Country:US
Mailing Address - Phone:907-339-9700
Mailing Address - Fax:907-339-9720
Practice Address - Street 1:1200 AIRPORT HEIGHTS DRIVE
Practice Address - Street 2:SUITE 280
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2943
Practice Address - Country:US
Practice Address - Phone:907-339-9700
Practice Address - Fax:907-339-9720
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA2087207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD9940Medicaid
AKMD9940Medicaid
000BKDNWMedicare ID - Type Unspecified