Provider Demographics
NPI:1295727428
Name:SCHLICHT, ALLAN G (MD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:G
Last Name:SCHLICHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 32578
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99803-2578
Mailing Address - Country:US
Mailing Address - Phone:907-789-1277
Mailing Address - Fax:907-789-2362
Practice Address - Street 1:2221 JORDAN AVE
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8050
Practice Address - Country:US
Practice Address - Phone:907-789-1277
Practice Address - Fax:907-789-3362
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK1952208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD19521Medicaid
E98271Medicare UPIN
AKMD19521Medicaid