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GLACIER FAMILY MEDICINE CLINIC LLC NPI 1942323779


NPI Information

NPI: 1942323779
Provider Name: GLACIER FAMILY MEDICINE CLINIC LLC
Classification: Physician Assistant - 363A00000X
Entity Type: Organization

CLIA Number: 02D0999338

Address:
11724 SEWARD HWY
STE D
SEWARD, AK
ZIP 99664
Phone: (907) 224-8733
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GLACIER FAMILY MEDICINE CLINIC LLC is a physician assistant in Seward, AK. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. GLACIER FAMILY MEDICINE CLINIC LLC NPI is 1942323779. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11724 SEWARD HWY
STE D
SEWARD, AK
ZIP 99664-714
Phone: (907) 224-8733
Fax: (907) 224-8734

The provider's authorized official is Brent Allen Ursel .
The authorized official title is Ceo Physician Assistant and has the following contact phone number (907) 224-8733.

The CLIA number assigned to this NPI record is 02D0999338 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/8/2007 and was last updated on 4/13/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363A00000XPhysician Assistant202ALASKAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERALASKANORTHWEST NPI SERVICE
2=========OTHERALASKABCBS
3=========OTHERALASKAOTHER PAR & NONPAR PAYERS
4MD22813MEDICAIDALASKA
5=========OTHERALASKAPREMARA
6152151MEDICARE PINALASKA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.