# FAIRBANKS VASCULAR SURGERY

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

## Provider details

- **NPI number:** 1972240562
- **Authorized official:** HARDEEP REDDICK PA (OWNER)
- **Authorized official phone:** (408) 800-8200

## Contact information

- **Practice address:** 2485 CHIEF WILLIAM DR STE 100, FAIRBANKS, AK 99709-4873
- **Practice address phone:** (907) 328-0965
- **Practice address fax:** (907) 457-5278
- **Mailing address:** 2485 CHIEF WILLIAM DR STE 100, FAIRBANKS, AK 99709-4873
- **Mailing address phone:** (907) 328-0965
- **Mailing address fax:** (907) 457-5278

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/16/2022
- **Last updated:** 06/21/2022