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Contact Information

EAR NOSE & THROAT CLINIC INC.
1919 LATHROP ST
SUITE 103
FAIRBANKS, AK99701-5937
 Phone: 907-456-7768
 Fax: 907-456-4045
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for EAR NOSE THROAT CLINIC INC · (Female)

NPI Number 1023179587
Status Active
Credentials
Entity Individual
Enumeration date 12/12/2006
Last updated 12/01/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers
  • AK License # 83561
  • AK Medicaid 1020915
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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