Provider Demographics
NPI:1912922576
Name:VON HAFFTEN, ALEXANDER H JR (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:H
Last Name:VON HAFFTEN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 DALE ST
Mailing Address - Street 2:STE 101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5428
Mailing Address - Country:US
Mailing Address - Phone:907-550-2300
Mailing Address - Fax:907-561-8646
Practice Address - Street 1:4001 DALE ST
Practice Address - Street 2:STE 101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5428
Practice Address - Country:US
Practice Address - Phone:907-550-2300
Practice Address - Fax:907-561-8646
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK31702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD31702Medicare ID - Type Unspecified
F67285Medicare UPIN