Organization
PEDIATRIC GASTROENTEROLOGY OF ALASKA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ALLAN PRATT M.D. (MANAGER)
(907) 276-5517
Entity
Organization
Contact information
Practice address
3340 PROVIDENCE DR, SUITE 567, ANCHORAGE, AK 99508-4616
(907) 276-5517
(907) 279-3655
Mailing address
3340 PROVIDENCE DR, SUITE 567, ANCHORAGE, AK 99508-4616
(907) 276-5517
(907) 279-3655
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
—
Other
Enumeration date
02/28/2007
Last updated
10/16/2007
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