Provider Demographics
NPI:1922495407
Name:DENALI ASTHMA AND PULMONARY, LLC
Entity Type:Organization
Organization Name:DENALI ASTHMA AND PULMONARY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHOTWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-770-5864
Mailing Address - Street 1:4001 LAUREL ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5300
Mailing Address - Country:US
Mailing Address - Phone:907-770-5864
Mailing Address - Fax:907-770-5868
Practice Address - Street 1:4001 LAUREL ST
Practice Address - Street 2:SUITE 206
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5300
Practice Address - Country:US
Practice Address - Phone:907-770-5864
Practice Address - Fax:907-770-5868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK7517207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty