Doctor Name: | VIRGINIA M AVILAHASKELL |
NPI Number: | 1982681151 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | A89929 |
Business Practice Address: | 1408 19th Ave Fairbanks, AK - 997015903 |
Business Phone Number: | 3109088828 |
Business Fax Number: | |
Mailing Address: | Po Box 73889, Dept Of Fm FAIRBANKS |
State: | AK |
Postal Code: | 997073889 |
Phone Number: | 3109088828 |
Fax Number: | |
NPI Enumeration Date: | 12/28/2005 |
NPI Last Update Date: | 05/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A89929 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |