# ISC KETCHIKAN-JUNEAU DETACHMENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497731590
- **Authorized official:** JUAN ESTEBAN PALACIO M.D. (CHIEF OF HEALTH SERVICES)
- **Authorized official phone:** (907) 463-2140

## Contact information

- **Practice address:** 709 W 9TH ST, USCG MEDICAL ROOM 627, JUNEAU, AK 99801-1807
- **Practice address phone:** (907) 463-2140
- **Mailing address:** 709 W 9TH ST, USCG MEDICAL ROOM 627, JUNEAU, AK 99801-1807

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/20/2005
- **Last updated:** 08/22/2020