Organization
DENALI SURGICAL SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON F LIEBERMAN M.D. (OWNER)
(907) 456-3100
Entity
Organization
Contact information
Practice address
1626 30TH AVE, SUITE 201, FAIRBANKS, AK 99701
(907) 456-3100
(907) 456-3141
Mailing address
1626 30TH AVE, SUITE 201, FAIRBANKS, AK 99701
(907) 456-3100
(907) 456-3141
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2658
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020522
—
AK
Enumeration date
04/09/2008
Last updated
05/09/2014
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