| NPI | 1285676841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RICHARD MAYER President 907-457-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AK 2974) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 3960) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2014-10-29 |