Organization
FAIRBANKS SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM H MONTANO MD (OFFICER)
(907) 452-8151
Entity
Organization
Contact information
Practice address
1919 LATHROP ST STE 204, FAIRBANKS, AK 99701-5942
(907) 452-8151
Mailing address
1919 LATHROP ST STE 204, FAIRBANKS, AK 99701-5942
(907) 452-8151
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD1335
AK
2086S0129X
Vascular Surgery Physician
MD1335
AK
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD1335
AK
Other
Enumeration date
02/08/2010
Last updated
12/17/2010
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