Provider Demographics
NPI:1962113977
Name:ALASKA ACUTE CARE AND TRAUMA SURGEONS, LLC
Entity type:Organization
Organization Name:ALASKA ACUTE CARE AND TRAUMA SURGEONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KONTNY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:907-519-6755
Mailing Address - Street 1:2741 DEBARR RD STE C415
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2998
Mailing Address - Country:US
Mailing Address - Phone:907-519-6755
Mailing Address - Fax:
Practice Address - Street 1:2741 DEBARR RD STE C415
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2998
Practice Address - Country:US
Practice Address - Phone:907-519-6755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty