Organization
MEDICAL NETWORK OF ALASKA, LLC
Active
Parent organization
MEDICAL NETWORK OF ALASKA, LLC
Other names
Alaska Fracture and Orthopedic Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL NETWORK OF ALASKA, LLC
Authorized official
JACQUELYN RENEE BLOMKER (DIRECTOR OF REVENUE CYCLE)
(907) 864-4625
Entity
Organization
Contact information
Practice address
4100 LAKE OTIS PKWY STE 220, ANCHORAGE, AK 99508-5230
(907) 563-3145
(907) 561-3967
Mailing address
3122 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7255
(907) 864-4625
(907) 357-9593
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2173058
STATE OF ALASKA BUSINESS LICENSE
AK
01
—
2173060
STATE OF ALASKA BUSINESS LICENSE
AK
01
—
2173061
STATE OF ALASKA BUSINESS LICENSE
AK
Enumeration date
01/17/2023
Last updated
01/17/2023
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