Provider Demographics
NPI:1629433701
Name:ALASKA BREAST CARE SPECIALISTS PC
Entity Type:Organization
Organization Name:ALASKA BREAST CARE SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARBOSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-222-2950
Mailing Address - Street 1:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-0379
Mailing Address - Country:US
Mailing Address - Phone:708-460-9833
Mailing Address - Fax:708-460-1117
Practice Address - Street 1:2741 DEBARR RD
Practice Address - Street 2:SUITE 402
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2961
Practice Address - Country:US
Practice Address - Phone:907-222-2950
Practice Address - Fax:907-222-5950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK8158208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty