| NPI | 1467559138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES J SIDDALL Owner 907-585-6415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 036) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2012-01-23 |