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DR. ROBERT LOREN BRIDGES M.D.
Diagnostic Radiology >> Radiology >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1366501876
Individual Registrant:DR. ROBERT LOREN BRIDGES M.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1751 E. GARDNER WAY SUITE B WASILLA, AK 99654 US
Tel: 907-357-1220 Fax: 907-357-1222
Tel: 907-357-1220 Fax: 907-357-1222
Contact information for business:
P.O. BOX 751 GIRDWOOD, AK 99587 US
Tel: 907-382-0952 Fax: 866-305-3886
Tel: 907-382-0952 Fax: 866-305-3886
Registration Information:
NPI: 1366501876
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 2085R0202X | Allopathic & Osteopathic Physicians Radiology Diagnostic Radiology | AK | 4098 |
| N | 2085N0904X | Allopathic & Osteopathic Physicians Radiology | AK | 4098 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| MDG1552 | AK | 05 | |
| STATE OF AK MEDICAL LICEN | 4098 | AK | 01 |
| MDG155 | AK | 05 | |
| MDG1551 | AK | 05 | |
| BLUE CROSS BLUE SHIELD | N2018 | AK | 01 |
| MD5606 | AK | 05 | |
| MDG1553 | AK | 05 |
