Individual
ROGER LOGAN ESTELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 452-8251
Mailing address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 452-8251
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
200560
AK
Other
Enumeration date
02/15/2023
Last updated
02/27/2023
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