Provider Demographics
NPI:1972552891
Name:EAR, NOSE AND THROAT SPECIALISTS ALASKA, INC.
Entity Type:Organization
Organization Name:EAR, NOSE AND THROAT SPECIALISTS ALASKA, INC.
Other - Org Name:ALYESKA CENTER FOR FACIAL PLASTIC SURGERY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SECRETARY / TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-563-3515
Mailing Address - Street 1:3831 PIPER STREET SUITE#S433
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-563-3515
Mailing Address - Fax:907-563-3541
Practice Address - Street 1:3831 PIPER STREET SUITE#S433
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-563-3515
Practice Address - Fax:907-563-3541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK160689Medicare PIN