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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.

NPI Number 1023179587
LBN Legal business name EAR NOSE & THROAT CLINIC INC.
Authorized official SAM KIM - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/12/2006
Last updated 12/01/2022 - About 4 years ago
Identifiers
AK License # 83561
AK Medicaid 1020915
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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