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4501 Diplomacy Dr Anchorage AK 99508-5919 | |
| (907) 729-4955 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 4501 Diplomacy Dr, Anchorage, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 35198 Seattle WA 98124-5198 Ph: () - | 4501 Diplomacy Dr Anchorage AK 99508-5919 Ph: (907) 729-4955 |
| NPI Number | 1710293006 |
|---|---|
| Provider Enumeration Date | 08/24/2010 |
| Last Update Date | 09/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710293006 | NPI | - | NPPES |
| 1701244 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 20467 (Alaska) | Primary |
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