Individual
MARK THOMAS ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3700 PIPER ST, ANCHORAGE, AK 99508-4665
(907) 269-7152
(907) 269-7246
Mailing address
3700 PIPER ST, ANCHORAGE, AK 99508-4665
(907) 269-7152
(907) 269-7246
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3995
AK
207Q00000X
Family Medicine Physician
3995
AK
2084P0800X
Psychiatry Physician
Primary
3995
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD96081
—
AK
Enumeration date
07/27/2006
Last updated
10/07/2016
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