| NPI | 1184010274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH E BEATY B Illing Agent 907-770-2380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AK 1018733) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2015-04-15 |