Organization
SURGICAL SPECIALISTS OF ALASKA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRE SHELTON (OPERATIONS ADMINISTRATOR)
(907) 748-7398
Entity
Organization
Contact information
Practice address
1690 W PIPESTONE DR, WASILLA, AK 99654-9741
(907) 230-3734
(866) 525-8738
Mailing address
5432 E NORTHERN LIGHTS BLVD # 510, ANCHORAGE, AK 99508-4713
(907) 230-3734
(866) 525-8738
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
10024226
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1002426
BUSINESS LICENSE
AK
Enumeration date
09/17/2014
Last updated
05/07/2018
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