SOUTH CENTRAL FAMILY PRACTICE CLINIC PC NPI 1003967753

NPI Information

NPI: 1003967753
Provider Name: SOUTH CENTRAL FAMILY PRACTICE CLINIC PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 02D1015482

Address:
161 N BINKLEY ST
SUITE 101
SOLDOTNA, AK
ZIP 99669
Phone: (907) 260-7784
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SOUTH CENTRAL FAMILY PRACTICE CLINIC PC is a family medicine in Soldotna, AK. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SOUTH CENTRAL FAMILY PRACTICE CLINIC PC NPI is 1003967753. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

161 N BINKLEY ST
SUITE 101
SOLDOTNA, AK
ZIP 99669
Phone: (907) 260-7784
Fax: (907) 260-7738

The provider's authorized official is Gladys J Bailon .
The authorized official title is President and has the following contact phone number (907) 260-7784.

The CLIA number assigned to this NPI record is 02D1015482 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/16/2007 and was last updated on 5/18/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		901044	ALASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GJ520	OTHER	ALASKA	PACIFIC SOURCE HEALTH
2	610985200	OTHER	ALASKA	OWCP FEDERAL WORKERS COMP
3	610985200	OTHER	ALASKA	OWCP FEDERAL BLACK LUNG

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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