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Organization
EAR NOSE & THROAT CLINIC INC.
Active
Organization
EAR NOSE & THROAT CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM Y KIM MD (PRESIDENT)
(907) 456-7768
Entity
Organization
Contact information
Practice address
1919 LATHROP ST, SUITE 103, FAIRBANKS, AK 99701-5937
(907) 456-7768
(907) 456-4045
Mailing address
1919 LATHROP ST., SUITE 103, FAIRBANKS, AK 99701-5937
(907) 456-7768
(907) 456-4045
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
83561
AK
207Y00000X
Otolaryngology Physician
Primary
—
NULL
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
12/12/2006
Last updated
12/01/2022
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