| NPI | 1073701421 |
|---|---|
| Doing Business As | LAVERN DAVIDHIZAR |
| Entity Type | Organization |
| Authorized Contact | LAVERN R DAVIDHIZAR President 907-262-7566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 1454) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AK 4221) |
| 207L00000X Anesthesiology (Licence: AK 4221) | |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2012-10-29 |