Provider Demographics
NPI:1063552115
Name:ALASKA NEUROLOGICAL SURGERY LLC
Entity type:Organization
Organization Name:ALASKA NEUROLOGICAL SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:P
Authorized Official - Last Name:KOHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-746-7479
Mailing Address - Street 1:2490 SOUTH WOODWORTH LOOP
Mailing Address - Street 2:SUITE 450
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645
Mailing Address - Country:US
Mailing Address - Phone:907-746-7479
Mailing Address - Fax:907-746-7477
Practice Address - Street 1:2490 SOUTH WOODWORTH LOOP
Practice Address - Street 2:SUITE 450
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645
Practice Address - Country:US
Practice Address - Phone:907-746-7479
Practice Address - Fax:907-746-7477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5237207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty