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Contact Information

FAIRBANKS SURGERY, LLC
1919 LATHROP ST STE 204
FAIRBANKS, AK99701-5942
 Phone: 907-452-8151
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Thoracic Surgery (Cardiothoracic Vascular Surgery)

208G00000X 02 Physician/General Surgery
 

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for FAIRBANKS SURGERY LLC · (Female)

NPI # 1790017291
Status Active
Credentials
Entity Individual
Enumeration date 02/08/2010
Last updated 12/17/2010 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers
  • AK License # MD1335
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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