Provider Demographics
NPI:1528253838
Name:ALASKA NEUROSCIENCE ASSOCIATES,LLC
Entity type:Organization
Organization Name:ALASKA NEUROSCIENCE ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:L
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-677-8737
Mailing Address - Street 1:3851 PIPER ST STE U431
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-6902
Mailing Address - Country:US
Mailing Address - Phone:907-677-8737
Mailing Address - Fax:907-677-9731
Practice Address - Street 1:3851 PIPER ST STE U431
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-6902
Practice Address - Country:US
Practice Address - Phone:907-677-8737
Practice Address - Fax:907-677-9731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty