OrganizationActive
Ear Nose & Throat Clinic Inc.
NPI 1023179587 · Otolaryngology Physician · Fairbanks, AK
Provider details
- NPI number
- 1023179587
- Entity type
- Organization
- Primary specialty
- Otolaryngology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Sam Kim, President(907) 456-7768
- License
- 83561 (AK)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1919 Lathrop St
Suite 103
Fairbanks, AK 99701-5937
Phone: (907) 456-7768
Fax: (907) 456-4045
Approximate (ZIP-level) locationGet directions
Mailing address
1919 Lathrop St.
Fairbanks, AK 99701-5937
Registry dates
- Enumerated
- 2006-12-12
- Last updated
- 2022-12-01
- Certified
- 2022-12-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.