Individual
DR. JESSICA ELLEN PANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1650 COWLES ST, FAIRBANKS, AK 99701-5999
(907) 452-6464
Mailing address
3427 E TUDOR RD, STE A, ANCHORAGE, AK 99507-1282
(907) 456-2784
(907) 452-1073
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD161185
OR
2085R0202X
Diagnostic Radiology Physician
Primary
S7195
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD9507
—
AK
Enumeration date
07/12/2007
Last updated
10/21/2016
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