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Individual

LAWRENCE JEDLICKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4001 LAUREL ST, ANCHORAGE, AK 99508-5300
(907) 677-1012
(907) 565-6001
Mailing address
4001 LAUREL ST, ANCHORAGE, AK 99508-5300
(907) 677-1012
(907) 565-6001

Taxonomy

Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
069361
GA
2084N0400X
Neurology Physician
22378
MS
2084N0400X
Neurology Physician
Primary
43103
KY

Other

Enumeration date
09/28/2006
Last updated
03/22/2018
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