National Provider Identifier Database

FAIRBANKS CANCER CARE PHYSICIANS
Hematology & Oncology

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.


Contact Information

FAIRBANKS CANCER CARE PHYSICIANS
1640 COWLES ST
SUITE 1
FAIRBANKS, AK99701-5925
Phone: 907-452-4768
Fax: 907-452-1009
Website:
Specialty Taxonomy Code
* Hematology & Oncology 207RH0003X

* Indicates primary specialty

NPI Profile & details for FAIRBANKS CANCER CARE PHYSICIANS

NPI Number 1386759470
Legal business name
LBN
FAIRBANKS CANCER CARE PHYSICIANS
Authorized official JACQUELINE COX - (CO-OWNER)
Entity Organization
Organization subpart No
Enumeration date 08/20/2006
Last updated 03/26/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • AK License #: 926150
  • AK Medicaid: MD14421
  • AK Medicaid: MD6153
  • AK Medicaid: MD69431
  • AK Medicaid: MDG543
  • AK Medicaid: MPG0088
  • AK Medicaid: NP7619

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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