Organization
CHEST MEDICINE FAIRBANKS,P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OWEN QUIGLEY HANLEY M.D. (PRESIDENT)
(907) 590-0695
Entity
Organization
Contact information
Practice address
1650 COWLES ST, FAIRBANKS, AK 99701-5998
(907) 456-3750
(907) 451-1701
Mailing address
PO BOX 71659, FAIRBANKS, AK 99707-1659
(907) 456-3750
(907) 451-1701
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
1350
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MDG499
—
AK
Enumeration date
03/26/2007
Last updated
12/15/2010
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