Individual
JACK ARLYN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4001 DALE ST, #201, ANCHORAGE, AK 99508-5428
(907) 561-1185
Mailing address
11060 BIRCH RD, ANCHORAGE, AK 99516-1711
(907) 346-2839
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0959
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD0959
—
AK
Enumeration date
02/07/2006
Last updated
07/08/2007
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