Provider Demographics
NPI:1821988866
Name:DRUSKIS, JUSTIN COLE (PA-C)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:COLE
Last Name:DRUSKIS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17311 BONASILA CIR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-8119
Mailing Address - Country:US
Mailing Address - Phone:402-378-2887
Mailing Address - Fax:
Practice Address - Street 1:1235 12TH AVE NW
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1578
Practice Address - Country:US
Practice Address - Phone:580-222-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK236746363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant