# MARK T. KOWAL MD PC

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

## Provider details

- **NPI number:** 1205112240
- **Authorized official:** DR. MARK TIMOTHY KOWAL MD (GENERAL SURGEON)
- **Authorized official phone:** (907) 451-5507

## Contact information

- **Practice address:** 1919 LATHROP ST, SUITE 202, FAIRBANKS, AK 99701-5937
- **Practice address phone:** (907) 451-5507
- **Practice address fax:** (907) 451-5590
- **Mailing address:** 1919 LATHROP ST, SUITE 202, FAIRBANKS, AK 99701-5937
- **Mailing address phone:** (907) 451-5507
- **Mailing address fax:** (907) 451-5590

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 7319 | AK | Yes |

## Other

- **Enumeration date:** 10/21/2011
- **Last updated:** 12/27/2016