Dr. Jeffrey Brent Roaten
Surgeon Pediatric Surgery
4100 Lake Otis Pkwy Ste 312
Anchorage
, Alaska 99508-5231
Dr. Jeffrey Brent Roaten
Surgeon Pediatric Surgery
4100 Lake Otis Pkwy Ste 312
Anchorage
, Alaska 99508-5231
(907) 929-7337
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About
Features
Specialties
- Surgeon
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Dr. Jeffrey Brent Roaten
- 4100 Lake Otis Pkwy Ste 312
- Anchorage, AK
- Zip : 99508-5231
- Phone : (907) 929-7337
Second Address
- Dr. Jeffrey Brent Roaten
- 4100 Lake Otis Pkwy Ste 312
- Anchorage, AK
- Zip : 99508-5231
- Phone : (907) 929-7337
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208200000X | Surgeon | 6550 | AK |
| Y | 208600000X | Surgeon | 6550 | AK |
| N | 2086S0120X | Pediatric Surgery | 43121 | TN |
National Provider Identifier
| NPI | 1558546788 |
|---|---|
| Provider Name | Dr. Jeffrey Brent Roaten |
| First Address | Anchorage, AK 99508-5231 |
| Second Address | Anchorage, AK 99508-5231 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/01/2008 |
| Last Update Date | 24/09/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| MD1272 | (05) | AK |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.