Provider Demographics
NPI:1578864575
Name:HEDBERG, JOSHUA D (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:D
Last Name:HEDBERG
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 LAKE OTIS PKWY
Mailing Address - Street 2:SUITE 322
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5229
Mailing Address - Country:US
Mailing Address - Phone:907-562-1234
Mailing Address - Fax:
Practice Address - Street 1:2841 DEBARR RD
Practice Address - Street 2:SUITE #22
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2958
Practice Address - Country:US
Practice Address - Phone:907-276-6301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-06
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK938363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant