Individual
NATHAN KASUKONIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2211 E NORTHERN LIGHTS BLVD, ANCHORAGE, AK 99508-4129
(907) 279-8486
(907) 677-5614
Mailing address
2211 E NORTHERN LIGHTS BLVD, ANCHORAGE, AK 99508-4129
(907) 257-8144
(907) 677-5614
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AK6583
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162616
MEDICAID GROUP NO
AK
05
—
MD2487
—
AK
Enumeration date
04/10/2007
Last updated
12/18/2013
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