| Lori D Conklin, MD | |
|
1650 Cowles St, Fairbanks, AK 99701-5998 | |
| (907) 458-3000 | |
| (907) 458-5694 |
| Full Name | Lori D Conklin |
|---|---|
| Gender | Female |
| Speciality | Anesthesiology |
| Experience | 28 Years |
| Location | 1650 Cowles St, Fairbanks, Alaska |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659350122 | NPI | - | NPPES |
| 1723344 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 179267 (Alaska) | Primary |
| 207L00000X | Anesthesiology | L1007 (Texas) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fairbanks Memorial Hospital | Fairbanks, AK | Hospital |
| Alaska Regional Hospital | Anchorage, AK | Hospital |
| Peacehealth Ketchikan Medical Center | Ketchikan, AK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Tanana Valley Clinic Llc | 5698056901 | 148 |
| Denali Anesthesia Llc | 2567455678 | 28 |
| Entity Name | Providence Anchorage Anesthesia Medical Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659368397 PECOS PAC ID: 2163414830 Enrollment ID: O20040401000952 |
| Mailing Address | Practice Location Address |
|---|---|
| Lori D Conklin, MD Po Box 73720, Fairbanks, AK 99707-3720 Ph: (907) 458-3000 | Lori D Conklin, MD 1650 Cowles St, Fairbanks, AK 99701-5998 Ph: (907) 458-3000 |
Bridget Humphries, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1650 Cowles St, Fairbanks, AK 99701 Phone: 800-945-9877 | |
Craig R. Thomas, D.O. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1919 Lathrop Street, Suite 107, Fairbanks, AK 99701 Phone: 907-452-4101 | |
Androcles Jay Lester, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1650 Cowles St, Fairbanks, AK 99701 Phone: 907-458-5681 | |
Nancy E Cross, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1275 Sadler Way, Suite 101, Fairbanks, AK 99701 Phone: 907-374-6602 Fax: 907-374-6604 | |
Diana L Kovacich, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1275 Sadler Way Ste 202, Fairbanks, AK 99701 Phone: 907-452-4101 | |
William Walter Quirk, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1650 Cowles St, Fairbanks, AK 99701 Phone: 907-458-5681 | |
Randall K Mcgregor, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1650 Cowles St, Fairbanks, AK 99701 Phone: 800-945-9877 Fax: 801-733-5618 |