Provider Demographics
NPI:1033909791
Name:ADVANCED FERTILITY OF ALASKA LLC
Entity type:Organization
Organization Name:ADVANCED FERTILITY OF ALASKA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-435-0555
Mailing Address - Street 1:4129 BARTLETT ST
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7002
Mailing Address - Country:US
Mailing Address - Phone:907-435-0555
Mailing Address - Fax:833-992-2172
Practice Address - Street 1:2665 E TUDOR RD STE 400B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1144
Practice Address - Country:US
Practice Address - Phone:907-435-0555
Practice Address - Fax:833-992-2172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty