| Fireside Family Medicine Llc | |
|
2957 Santa Patricia Ct North Pole AK 99705-6138 | |
| (907) 385-0257 | |
| (907) 385-0249 |
| Full Name | Fireside Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2957 Santa Patricia Ct, North Pole, Alaska |
| Authorized Official Name and Position | Bart Worthington (OWNER) |
| Authorized Official Contact | 6062345183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fireside Family Medicine Llc 2957 Santa Patricia Ct North Pole AK 99705-6138 Ph: (907) 385-0257 | Fireside Family Medicine Llc 2957 Santa Patricia Ct North Pole AK 99705-6138 Ph: (907) 385-0257 |
| NPI Number | 1831702455 |
|---|---|
| Provider Enumeration Date | 08/24/2020 |
| Last Update Date | 08/20/2021 |
| Medicare PECOS PAC ID | 2668892373 |
|---|---|
| Medicare Enrollment ID | O20201019002998 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831702455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Bart D Worthington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205274347 PECOS PAC ID: 9739481193 Enrollment ID: I20200929002996 |
Peter Marshall, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 145 Santa Claus Lane, North Pole, AK 99705 Phone: 907-488-4433 Fax: 907-488-9253 |