| Wild Iris Family Medicine And Maternity Care | |
|
851 E Westpoint Dr Suite 207 Wasilla AK 99654-7183 | |
| (907) 373-9463 | |
| Not Available |
| Full Name | Wild Iris Family Medicine And Maternity Care |
|---|---|
| Speciality | Family Medicine |
| Location | 851 E Westpoint Dr, Wasilla, Alaska |
| Authorized Official Name and Position | Lisa Harrison (OWNER/PHYSICIAN) |
| Authorized Official Contact | 9073739463 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Iris Family Medicine And Maternity Care 851 E Westpoint Dr Suite 207 Wasilla AK 99654-7183 Ph: (907) 373-9463 | Wild Iris Family Medicine And Maternity Care 851 E Westpoint Dr Suite 207 Wasilla AK 99654-7183 Ph: (907) 373-9463 |
| NPI Number | 1003244211 |
|---|---|
| Provider Enumeration Date | 10/25/2013 |
| Last Update Date | 10/20/2014 |
| Medicare PECOS PAC ID | 0042447724 |
|---|---|
| Medicare Enrollment ID | O20131230001985 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003244211 | NPI | - | NPPES |
| 1012605 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5448 (Alaska) | Primary |
| Provider Name | Lisa L Harrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821004383 PECOS PAC ID: 5597712653 Enrollment ID: I20050331001289 |
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