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Organization

ORTHOPAEDIC TRIAGE OF FAIRBANKS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL T WEBER PA-C (PRESIDENT)
(907) 452-4446
Entity
Organization

Contact information

Practice address
1919 LATHROP, SUITE 209, FAIRBANKS, AK 99701
(907) 452-4469
(907) 451-9480
Mailing address
1919 LATHROP, SUITE 209, FAIRBANKS, AK 99701
(907) 452-4469
(907) 451-9480

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
171
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MD45451
AK
Enumeration date
03/27/2008
Last updated
07/24/2013
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