Individual
TIMOTHY J FAGGIONATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3260 PROVIDENCE DR, SUITE 200, ANCHORAGE, AK 99508-4615
(907) 563-3145
(907) 561-3967
Mailing address
3260 PROVIDENCE DR, SUITE 200, ANCHORAGE, AK 99508-4615
(907) 563-3145
(907) 561-3967
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
444
AK
Other
Enumeration date
06/18/2006
Last updated
10/22/2007
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