Kachemak Bay Medical Clinic | |
4201 Bartlett St Ste 202 Homer AK 99603-7004 | |
(907) 235-7000 | |
(907) 235-4050 |
Full Name | Kachemak Bay Medical Clinic |
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Speciality | Family Medicine |
Location | 4201 Bartlett St Ste 202, Homer, Alaska |
Authorized Official Name and Position | Paul David Raymond (PRESIDENT) |
Authorized Official Contact | 9072357000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kachemak Bay Medical Clinic 4201 Bartlett St Ste 202 Homer AK 99603-7004 Ph: (907) 235-7000 | Kachemak Bay Medical Clinic 4201 Bartlett St Ste 202 Homer AK 99603-7004 Ph: (907) 235-7000 |
NPI Number | 1770651762 |
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Provider Enumeration Date | 11/30/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 4981516259 |
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Medicare Enrollment ID | O20031104000601 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770651762 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Paul W Davis |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467462887 PECOS PAC ID: 6709952880 Enrollment ID: I20140618000277 |
Homer Medical Clinic, A Professional Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4136 Bartlett St, Homer, AK 99603 Phone: 907-235-8586 Fax: 907-235-6639 |