Individual
RANDALL HABECKER WIEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4136 BARTLETT ST, HOMER MEDICAL CLINIC, HOMER, AK 99603-7001
(907) 235-8586
(907) 235-6639
Mailing address
PO BOX 1489, HOMER, AK 99603-1489
(907) 235-8586
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AA 1925
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080153698
RAILROAD MEDICARE
—
05
—
MD19252
—
AK
Enumeration date
02/21/2007
Last updated
03/07/2023
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