| NPI | 1326900093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY SEAN KAVANAUGH Owner Md 907-351-7502 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2025-12-01 |
| Last Update Date | 2025-12-01 |