PEACEHEALTH NPI 1801965736

NPI Information

NPI: 1801965736
Provider Name: PEACEHEALTH

Doing Business As: KETCHIKAN MEDICAL CENTER

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
3100 TONGASS AVE
KETCHIKAN, AK
ZIP 99901
Phone: (907) 228-8300
Get Directions

PEACEHEALTH is a diagnostic radiology radiology in Ketchikan, AK. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. PEACEHEALTH NPI is 1801965736. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Ketchikan Medical Center.

The provider's business location address is:

3100 TONGASS AVE
KETCHIKAN, AK
ZIP 99901-746
Phone: (907) 228-8300
Fax: (907) 228-8518

The provider's authorized official is Patrick J Branco .
The authorized official title is Ceo and has the following contact phone number (907) 228-8300.

The enumeration date for this NPI number is 11/7/2006 and was last updated on 8/31/2011.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	176B00000X	Midwife			ALASKA	No
2	207L00000X	Anesthesiology			ALASKA	No
3	207P00000X	Emergency Medicine			ALASKA	No
4	207Q00000X	Family Medicine			ALASKA	No
5	207R00000X	Internal Medicine			ALASKA	No
6	207V00000X	Obstetrics & Gynecology			ALASKA	No
7	207X00000X	Orthopaedic Surgery		NO NUMBERS ISSUED	ALASKA	No
8	207ZP0102X	Pathology	Anatomic Pathology & Clinical Pathology	NO NUMBERS ISSUED	ALASKA	No
9	208000000X	Pediatrics		NO NUMBERS ISSUED	ALASKA	No
10	2084P0800X	Psychiatry & Neurology	Psychiatry	NO NUMBERS ISSUED	ALASKA	No
11	208600000X	Surgery		NO NUMBERS ISSUED	ALASKA	No
12	367500000X	Nurse Anesthetist, Certified Registered			ALASKA	No
13	207RS0012X	Internal Medicine	Sleep Medicine		ALASKA	No
14	2085R0202X	Radiology	Diagnostic Radiology	NO NUMBERS ISSUED	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	6110165	OTHER	ALASKA	AETNA HOSPITAL PRO#
2	K0000ZBBBL	MEDICARE PIN	ALASKA
3	MDG235	MEDICAID	ALASKA
4	7695464	OTHER	ALASKA	AETNA CLINIC PRO#

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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