Provider Demographics
NPI:1942352117
Name:WILLIAM E ERICKSON ANP PC
Entity Type:Organization
Organization Name:WILLIAM E ERICKSON ANP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:907-561-1332
Mailing Address - Street 1:4050 LAKE OTIS PKWY
Mailing Address - Street 2:STE102
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5212
Mailing Address - Country:US
Mailing Address - Phone:907-561-1332
Mailing Address - Fax:907-562-1446
Practice Address - Street 1:4050 LAKE OTIS PKWY
Practice Address - Street 2:STE102
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5212
Practice Address - Country:US
Practice Address - Phone:907-561-1332
Practice Address - Fax:907-562-1446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK725261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP47963Medicaid
AKP97919Medicare UPIN
AKNP47963Medicaid