Organization
THAT'S MY PEDS GI PEDIATRIC GASTROENTEROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH E BEATY (BILLING AGENT)
(907) 770-2380
Entity
Organization
Contact information
Practice address
4120 LAUREL ST, SUITE 201, ANCHORAGE, AK 99508-5392
(907) 743-6944
(907) 743-0694
Mailing address
PO BOX 241769, ANCHORAGE, AK 99524-1769
(907) 770-2380
(907) 770-2341
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
984995
AK
Other
Enumeration date
03/20/2013
Last updated
12/30/2016
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