JUNEAU OBSTETRICS AND GYNECOLOGY P.C. NPI 1184160905

NPI Information

NPI: 1184160905
Provider Name: JUNEAU OBSTETRICS AND GYNECOLOGY, P.C.

Former Legal Business Name: NELL ANN WAGONER, M.D., P.C.

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
3268 HOSPITAL DR
SUITE B
JUNEAU, AK
ZIP 99801
Phone: (907) 586-1717
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JUNEAU OBSTETRICS AND GYNECOLOGY, P.C. is an ambulatory surgical clinic center in Juneau, AK. JUNEAU OBSTETRICS AND GYNECOLOGY, P.C. NPI is 1184160905. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Nell Ann Wagoner, M.d., P.c..

The provider's business location address is:

3268 HOSPITAL DR
SUITE B
JUNEAU, AK
ZIP 99801-800
Phone: (907) 586-1717
Fax: (907) 586-2677

The provider's authorized official is Nicholas D. Newbury .
The authorized official title is President and has the following contact phone number (907) 586-1717.

The enumeration date for this NPI number is 1/18/2017 and was last updated on 7/29/2017.

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	261QA1903X	Clinic/Center	Ambulatory Surgical	MD2531	ALASKA	No
2	261QM2500X	Clinic/Center	Medical Specialty	NP0168	ALASKA	No
3	261QA1903X	Clinic/Center	Ambulatory Surgical	107902	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	K152091	MEDICARE UPIN
2	1020712	MEDICAID	ALASKA

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

NPI Synchronization or Removal

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