# MEDICAL NETWORK OF ALASKA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CAPSTONE FAMILY MEDICINE, LLC
- **Other names:** Capstone Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1013551456
- **Legal business name:** CAPSTONE FAMILY MEDICINE, LLC
- **Authorized official:** JACQUELYN RENEE BLOMKER (RCM)
- **Authorized official phone:** (907) 864-4625

## Contact information

- **Practice address:** 10543 KENAI SPUR HWY, KENAI, AK 99611-7812
- **Practice address phone:** (907) 357-9590
- **Practice address fax:** (907) 357-9593
- **Mailing address:** 3122 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7255
- **Mailing address phone:** (907) 357-9590
- **Mailing address fax:** (907) 357-9593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 10/29/2019
- **Last updated:** 11/02/2020