Provider Demographics
NPI:1841796869
Name:SURGICAL SPECIALISTS OF ALASKA
Entity Type:Organization
Organization Name:SURGICAL SPECIALISTS OF ALASKA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-277-9700
Mailing Address - Street 1:2751 DEBARR RD STE 310
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-6804
Mailing Address - Country:US
Mailing Address - Phone:907-277-9700
Mailing Address - Fax:907-258-8010
Practice Address - Street 1:2751 DEBARR RD STE 310
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-277-9700
Practice Address - Fax:907-258-8010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care