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KACHEMAK BAY MEDICAL CLINIC NPI 1770651762


NPI Information

NPI: 1770651762
Provider Name: KACHEMAK BAY MEDICAL CLINIC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 02D0696235

Address:
4201 BARTLETT ST STE 202
HOMER, AK
ZIP 99603
Phone: (907) 235-7000
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KACHEMAK BAY MEDICAL CLINIC is a family medicine in Homer, 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. KACHEMAK BAY MEDICAL CLINIC NPI is 1770651762. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4201 BARTLETT ST STE 202
HOMER, AK
ZIP 99603-004
Phone: (907) 235-7000
Fax: (907) 235-4050

The provider's authorized official is Paul David Raymond .
The authorized official title is President and has the following contact phone number (907) 235-7000.

The CLIA number assigned to this NPI record is 02D0696235 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/30/2006 and was last updated on 8/22/2020.


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
1207Q00000XFamily MedicineYes

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

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