# MEDICAL NETWORK OF ALASKA, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDICAL NETWORK OF ALASKA, LLC
- **Other names:** Alaska Fracture and Orthopedic Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1326753021
- **Legal business name:** MEDICAL NETWORK OF ALASKA, LLC
- **Authorized official:** JACQUELYN RENEE BLOMKER (DIRECTOR OF REVENUE CYCLE)
- **Authorized official phone:** (907) 864-4625

## Contact information

- **Practice address:** 4100 LAKE OTIS PKWY STE 220, ANCHORAGE, AK 99508-5230
- **Practice address phone:** (907) 563-3145
- **Practice address fax:** (907) 561-3967
- **Mailing address:** 3122 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7255
- **Mailing address phone:** (907) 864-4625
- **Mailing address fax:** (907) 357-9593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 01/17/2023
- **Last updated:** 01/17/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2173058 | STATE OF ALASKA BUSINESS LICENSE | AK |
| 01 | — | 2173060 | STATE OF ALASKA BUSINESS LICENSE | AK |
| 01 | — | 2173061 | STATE OF ALASKA BUSINESS LICENSE | AK |