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Individual

EDGAR PRENTISS COLTHARP JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3300 ARCTIC BLVD, # 101, ANCHORAGE, AK 99503-4523
(907) 561-3488
(907) 562-3488
Mailing address
12032 COPPER MOUNTAIN DR, EAGLE RIVER, AK 99577-7304
(907) 694-1173

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
729
AK

Other

Enumeration date
03/06/2007
Last updated
03/07/2023
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