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is a Pain Medicine - Interventional Pain Medicine based in Eagle River, Alaska. is licensed to practice in * (Not Available) (license number ) and their current practice location is 10928 Eagle River Rd, # 104, Eagle River, Alaska. It can be reached at their office (for appointments etc.) via phone at (907) 622-1300.

NPI number for is 1053762062 and their current mailing address is 10928 Eagle River Rd, # 104, Eagle River, Alaska. does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1053762062.

Contact Information

10928 Eagle River Rd, # 104,
Eagle River, AK 99577-8078
(907) 622-1300
Not Available

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityPain Medicine - Interventional Pain Medicine
Location10928 Eagle River Rd, Eagle River, Alaska
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1053762062
  • Provider Enumeration Date: 06/30/2016
  • Last Update Date: 02/22/2017

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053762062NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
111N00000XChiropractor (* (Not Available))Secondary
208VP0014XPain Medicine - Interventional Pain Medicine (* (Not Available))Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

10928 Eagle River Rd, # 104,
Eagle River, AK 99577-8078

Ph: (907) 622-1300
10928 Eagle River Rd, # 104,
Eagle River, AK 99577-8078

Ph: (907) 622-1300

Reviews and Comments



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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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