Individual
EUGENE THOMAS PRYKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
INDEPENDENT DUTY HS
Contact information
Practice address
500A SENTINEL ISLAND AVE, KODIAK, AK 99615-6849
(602) 570-8173
Mailing address
500A SENTINEL ISLAND AVE, KODIAK, AK 99615-6849
(602) 570-8173
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D03353518
TRICARE
AZ
Enumeration date
09/23/2021
Last updated
09/23/2021
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