Organization
MANIILAQ ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL HANSON (ADMINISTRATOR)
(907) 442-3321
Entity
Organization
Contact information
Practice address
436 5TH & TED STEVENS WAY, KOTZEBUE, AK 99752
(907) 442-3321
(907) 442-7250
Mailing address
PO BOX 43, KOTZEBUE, AK 99752-0043
(907) 442-3321
(907) 442-7250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
234051
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MDG113
—
AK
Enumeration date
05/23/2007
Last updated
08/22/2020
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