Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
ODYSSEY FAMILY PRACTICE
Active
Organization
ODYSSEY FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED LEE WALLACE PA-C (OWNER)
(907) 313-4569
Entity
Organization
Contact information
Practice address
11595 KENAI SPUR HIGHWAY, KENAI, AK 99611
(907) 313-4569
(907) 313-4939
Mailing address
PO BOX 922, KASILOF, AK 99610-0922
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
NULL
291U00000X
Clinical Medical Laboratory
—
NULL
Other
Enumeration date
03/06/2019
Last updated
12/01/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers