| Kenneth G Youngberg Pc | |
|
232 W Rockwell Ave Soldotna AK 99669-7411 | |
| (907) 953-7303 | |
| Not Available |
| Full Name | Kenneth G Youngberg Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 232 W Rockwell Ave, Soldotna, Alaska |
| Authorized Official Name and Position | Kenneth G Youngberg (OWNER) |
| Authorized Official Contact | 9079537303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth G Youngberg Pc 47360 Philosopher Ct Soldotna AK 99669-9259 Ph: (907) 953-7303 | Kenneth G Youngberg Pc 232 W Rockwell Ave Soldotna AK 99669-7411 Ph: (907) 953-7303 |
| NPI Number | 1568935245 |
|---|---|
| Provider Enumeration Date | 01/06/2019 |
| Last Update Date | 01/06/2019 |
| Medicare PECOS PAC ID | 0648510941 |
|---|---|
| Medicare Enrollment ID | O20190325000787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568935245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Ken Youngberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609170133 PECOS PAC ID: 0143133504 Enrollment ID: I20160902000529 |
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