Provider Demographics
NPI:1720770928
Name:TRAVEL MEDICINE AND INFECTIOUS DISEASES OF ALASKA, LLC
Entity type:Organization
Organization Name:TRAVEL MEDICINE AND INFECTIOUS DISEASES OF ALASKA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-530-3680
Mailing Address - Street 1:3500 LATOUCHE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4248
Mailing Address - Country:US
Mailing Address - Phone:907-561-4362
Mailing Address - Fax:907-563-4498
Practice Address - Street 1:3500 LATOUCHE ST STE 200
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4248
Practice Address - Country:US
Practice Address - Phone:907-561-4362
Practice Address - Fax:907-563-4498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty