Male or Other

Jack A. Smith M.D.

Otolaryngology Physician in Anchorage, AK(View on Map)

Full Name

Jack Arlyn Smith M.D.

NPI Number

1194797662

NPI Type

Individual Provider

Gender

Male

Enumeration Date

02/07/2006

Specialties

(Taxonomies)

Code

207Y00000X

Primary Taxonomy

Yes

Licenses

State

Alaska

License Number

0959

Contact
Information

Purpose

Mailing
Location

Address

11060 BIRCH RD
4001 DALE ST

City

Anchorage
Anchorage

State

AK
AK

Postal Code

99516-1711
99508-5428

Country

US
US

Telephone Number

(907) 346-2839
(907) 561-1185

Identifiers

Identifier

MD0959

Identifier State

AK

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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