Individual
MR. JON ANTHONY KOIVUNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
351 W SWANSON AVENUE, SUITE 4, WASILLA, AK 99654-6853
(907) 376-5228
(907) 376-8126
Mailing address
351 W SWANSON AVENUE, SUITE 4, WASILLA, AK 99654-6853
(907) 376-5228
(907) 376-8126
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD1355
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043921
FAA
AK
05
—
MD1355
—
AK
Enumeration date
11/28/2006
Last updated
07/08/2007
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