| Katy Sheridan Md Pc | |
|
154 W Marydale Ave Soldotna AK 99669-7501 | |
| (907) 260-3121 | |
| (907) 260-4022 |
| Full Name | Katy Sheridan Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 154 W Marydale Ave, Soldotna, Alaska |
| Authorized Official Name and Position | Katy Marie Sheridan (OWNER) |
| Authorized Official Contact | 9072603121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katy Sheridan Md Pc 154 W Marydale Ave Soldotna AK 99669-7501 Ph: (907) 260-3121 | Katy Sheridan Md Pc 154 W Marydale Ave Soldotna AK 99669-7501 Ph: (907) 260-3121 |
| NPI Number | 1992814818 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/30/2016 |
| Medicare PECOS PAC ID | 3173761715 |
|---|---|
| Medicare Enrollment ID | O20130521000487 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992814818 | NPI | - | NPPES |
| 1581953 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3723 (Alaska) | Primary |
| Provider Name | Katy M Sheridan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518983246 PECOS PAC ID: 1759277965 Enrollment ID: I20040225000278 |
| Provider Name | Jennifer Wooley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972065910 PECOS PAC ID: 8921338997 Enrollment ID: I20221129001404 |
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