| Northwoods Family Medicine, Inc | |
|
1301 E. Palmer-wasilla Hwy, #400 Wasilla AK 99654 | |
| (907) 357-9400 | |
| Not Available |
| Full Name | Northwoods Family Medicine, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1301 E. Palmer-wasilla Hwy, #400, Wasilla, Alaska |
| Authorized Official Name and Position | Myles Standish (REPRESENTATIVE/AGENT) |
| Authorized Official Contact | 2063003992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwoods Family Medicine, Inc Po Box 876628 Wasilla AK 99687-6628 Ph: (907) 357-9400 | Northwoods Family Medicine, Inc 1301 E. Palmer-wasilla Hwy, #400 Wasilla AK 99654 Ph: (907) 357-9400 |
| NPI Number | 1528503687 |
|---|---|
| Provider Enumeration Date | 12/28/2016 |
| Last Update Date | 12/28/2016 |
| Medicare PECOS PAC ID | 0648554741 |
|---|---|
| Medicare Enrollment ID | O20170309002661 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528503687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 4823 (Alaska) | Primary |
| 363AM0700X | Physician Assistant - Medical | 340 (Alaska) | Secondary |
| Provider Name | Mary A Egbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174703268 PECOS PAC ID: 6901893940 Enrollment ID: I20040430000423 |
| Provider Name | Frank A Greathouse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780699330 PECOS PAC ID: 8325102536 Enrollment ID: I20090203000611 |
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