Organization
FAIRBANKS PSYCHIATRIC AND NEUROLOGICAL CLINIC A PROF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH E BEATY (BILLING AGENT)
(907) 770-2301
Entity
Organization
Contact information
Practice address
1919 LATHROP ST, SUITE 220, FAIRBANKS, AK 99701-5937
(907) 452-1739
(907) 452-2384
Mailing address
1919 LATHROP ST, SUITE 220, FAIRBANKS, AK 99701-5937
(907) 770-2301
(907) 770-2341
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
08/25/2006
Last updated
01/16/2019
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