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Organization

FAIRBANKS PAIN CONSULTING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHAN JIANG M.D. (PRESIDENT)
(907) 458-5638
Entity
Organization

Contact information

Practice address
1919 LATHROP ST, SUITE 221, FAIRBANKS, AK 99701-5937
(907) 458-5638
(907) 458-6415
Mailing address
3030 DAVIS RD, C7, FAIRBANKS, AK 99709-5233
(907) 460-0222
(907) 458-6415

Taxonomy

Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
124884
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MD2985
AK
Enumeration date
11/16/2009
Last updated
11/16/2009
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