| Doctor Name: | JOSE PRIMO N ANZILOTTI |
| NPI Number: | 1619955606 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 4141 |
| Business Practice Address: | Parks Highway Mile 69.1 Willow, AK - 99688 |
| Business Phone Number: | 9074954362 |
| Business Fax Number: | 9074954363 |
| Mailing Address: | Po Box 241769, ANCHORAGE |
| State: | AK |
| Postal Code: | 995241769 |
| Phone Number: | 9077702380 |
| Fax Number: | 9077702390 |
| NPI Enumeration Date: | 01/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4141 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |