Organization
EYE CLINIC OF FAIRBANKS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD W. ZAMBER M.D. (PRESIDENT)
(907) 456-7760
Entity
Organization
Contact information
Practice address
116 MINNIE ST, FAIRBANKS, AK 99701-3006
(907) 456-7760
(907) 451-7916
Mailing address
116 MINNIE ST, FAIRBANKS, AK 99701-3006
(907) 456-7760
(907) 451-7916
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
292621
AK
156FX1800X
Optician
292621
AK
207W00000X
Ophthalmology Physician
Primary
292621
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A0330
BLUE CROSS
AK
05
—
MDG576
—
AK
Enumeration date
12/15/2009
Last updated
06/22/2012
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