Provider Demographics
NPI:1154386944
Name:TROMBLEY, DALE J II (MD)
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:J
Last Name:TROMBLEY
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18502 POTTER GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-6137
Mailing Address - Country:US
Mailing Address - Phone:907-903-3347
Mailing Address - Fax:800-201-4576
Practice Address - Street 1:1200 AIRPORT HEIGHTS DR
Practice Address - Street 2:STE. E-245
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2965
Practice Address - Country:US
Practice Address - Phone:907-222-6001
Practice Address - Fax:907-222-6003
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK1561207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1561OtherLICENSE
AKMD15612Medicaid
AKMD15612Medicaid
AK1561OtherLICENSE
AKK152450Medicare ID - Type Unspecified