Provider Demographics
NPI:1013296755
Name:FRONTIER HEALTH SERVICES, P.C.
Entity Type:Organization
Organization Name:FRONTIER HEALTH SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELWIN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HJELLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:907-222-6688
Mailing Address - Street 1:PO BOX 241889
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99524-1889
Mailing Address - Country:US
Mailing Address - Phone:907-751-8138
Mailing Address - Fax:807-264-7464
Practice Address - Street 1:4241 B STREET
Practice Address - Street 2:SUITE 305
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-222-6688
Practice Address - Fax:800-556-6916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-12
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK66212084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD1521Medicaid