| Clarice Grandpre Md Llc | |
|
995 Ellesmere Dr Fairbanks AK 99709-5759 | |
| (907) 479-8101 | |
| Not Available |
| Full Name | Clarice Grandpre Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 995 Ellesmere Dr, Fairbanks, Alaska |
| Authorized Official Name and Position | Clarice Grandpre (OWNER) |
| Authorized Official Contact | 9074798101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarice Grandpre Md Llc Po Box 84945 Fairbanks AK 99708-4945 Ph: (907) 479-8101 | Clarice Grandpre Md Llc 995 Ellesmere Dr Fairbanks AK 99709-5759 Ph: (907) 479-8101 |
| NPI Number | 1598103095 |
|---|---|
| Provider Enumeration Date | 06/06/2013 |
| Last Update Date | 06/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598103095 | NPI | - | NPPES |
| 1610205 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2983 (Alaska) | Primary |
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