| Howard F. Detwiler Jr. M.d. | |
|
4141 B St Ste 302 Anchorage AK 99503-5942 | |
| (907) 770-0585 | |
| (907) 770-0586 |
| Full Name | Howard F. Detwiler Jr. M.d. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4141 B St Ste 302, Anchorage, Alaska |
| Authorized Official Name and Position | Howard Frederick Detwiler (OWNER) |
| Authorized Official Contact | 9077700585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Howard F. Detwiler Jr. M.d. 4141 B St Ste 302 Anchorage AK 99503-5942 Ph: (907) 770-0585 | Howard F. Detwiler Jr. M.d. 4141 B St Ste 302 Anchorage AK 99503-5942 Ph: (907) 770-0585 |
| NPI Number | 1164899282 |
|---|---|
| Provider Enumeration Date | 08/24/2015 |
| Last Update Date | 10/21/2022 |
| Certification Date | 10/21/2022 |
| Medicare PECOS PAC ID | 4688003460 |
|---|---|
| Medicare Enrollment ID | O20200330002046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164899282 | NPI | - | NPPES |
| 1632339 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 2849 (Alaska) | Primary |
| Provider Name | Howard Frederick Detwiler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649257460 PECOS PAC ID: 0749380608 Enrollment ID: I20070709000195 |
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