# PEDIATRIC NEUROLOGY CLINIC OF ALASKA, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164769204
- **Authorized official:** RODERIC SMITH III M.D. (PRESIDENT)
- **Authorized official phone:** (907) 562-6310

## Contact information

- **Practice address:** 2401 E 42ND AVE, SUITE 306, ANCHORAGE, AK 99508-5228
- **Practice address phone:** (907) 562-6300
- **Practice address fax:** (907) 562-6305
- **Mailing address:** 2401 E 42ND AVE, SUITE 306, ANCHORAGE, AK 99508-5228
- **Mailing address phone:** (907) 562-6300
- **Mailing address fax:** (907) 562-6305

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 4904 | AK | Yes |

## Other

- **Enumeration date:** 01/09/2013
- **Last updated:** 01/09/2013