OrganizationActive
Medical Network of Alaska, LLC
NPI 1710667902 · Surgery Physician · Wasilla, AK
Provider details
- NPI number
- 1710667902
- Entity type
- Organization
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Medical Network of Alaska, LLC
- Organization subpart
- Yes
- Authorized official
- Jacquelyn Blomker, Director of Revenue Cycle(907) 357-9590
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3066 E Meridian Park Loop
Wasilla, AK 99654-7254
Phone: (907) 357-2332
Approximate (ZIP-level) locationGet directions
Mailing address
3122 E Meridian Park Loop
Wasilla, AK 99654-7255
Other names (DBA / former)
- Doing business as
- Capstone Surgical Specialists
Registry dates
- Enumerated
- 2023-07-21
- Last updated
- 2023-07-21
- Certified
- 2023-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.