# SURGICAL SPECIALISTS OF ALASKA LLC

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

## Provider details

- **NPI number:** 1265834782
- **Authorized official:** KERRE SHELTON (OPERATIONS ADMINISTRATOR)
- **Authorized official phone:** (907) 748-7398

## Contact information

- **Practice address:** 1690 W PIPESTONE DR, WASILLA, AK 99654-9741
- **Practice address phone:** (907) 230-3734
- **Practice address fax:** (866) 525-8738
- **Mailing address:** 5432 E NORTHERN LIGHTS BLVD \# 510, ANCHORAGE, AK 99508-4713
- **Mailing address phone:** (907) 230-3734
- **Mailing address fax:** (866) 525-8738

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 10024226 | AK | Yes |

## Other

- **Enumeration date:** 09/17/2014
- **Last updated:** 05/07/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1002426 | BUSINESS LICENSE | AK |