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Organization
TANANA VALLEY MEDICAL SURGICAL GROUP INC
Active
Organization
TANANA VALLEY MEDICAL SURGICAL GROUP INC
Active
Other names
Tanana Valley Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES SHILL MBA (CEO)
(907) 459-3509
Entity
Organization
Contact information
Practice address
1001 NOBLE ST, FAIRBANKS, AK 99701-4922
(907) 459-3507
(907) 459-3532
Mailing address
1001 NOBLE ST, FAIRBANKS, AK 99701-4922
(907) 459-3507
(907) 459-3532
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE7854
MEDICARE RAILROAD
AK
05
—
GR0118
—
AK
Enumeration date
03/02/2006
Last updated
05/24/2012
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