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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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1020915
AK
Enumeration date
12/12/2006
Last updated
12/01/2022
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