Organization
LASER VEIN CENTER OF FAIRBANKS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD IVES MD (MANAGER)
(907) 452-8346
Entity
Organization
Contact information
Practice address
506 GAFFNEY RD, SUITE 300, FAIRBANKS, AK 99701-4914
(907) 452-8346
Mailing address
PO BOX 440, ESTER, AK 99725-0440
(907) 452-8346
(907) 451-8346
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
Other
Enumeration date
04/06/2009
Last updated
04/06/2009
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