KIM THIELE DO PC NPI 1972894418

NPI Information

NPI: 1972894418
Provider Name: KIM THIELE, DO, PC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
105 TRADING BAY DR
SUITE 105
KENAI, AK
ZIP 99611
Phone: (907) 242-9000
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KIM THIELE, DO, PC is a primary care clinic center in Kenai, AK. KIM THIELE, DO, PC NPI is 1972894418. The provider is registered as an organization entity type.

The provider's business location address is:

105 TRADING BAY DR
SUITE 105
KENAI, AK
ZIP 99611-717
Phone: (907) 242-9000

The provider's authorized official is Kim E Thiele .
The authorized official title is Executive Officer and has the following contact phone number (907) 242-9000.

The enumeration date for this NPI number is 5/2/2011 and was last updated on 5/2/2011.

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	261QP2300X	Clinic/Center	Primary Care	4125	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	D76005	MEDICARE UPIN
2	MD41253	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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