Organization
PENINSULA INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM JOSEPH KELLEY MD (OWNER CORPORATE VICE PRESIDENT)
(907) 262-8597
Entity
Organization
Contact information
Practice address
247 N FIREWEED ST, STE A, SOLDOTNA, AK 99669-7540
(907) 262-8597
(907) 262-6516
Mailing address
247 N FIREWEED, STE A, SOLDOTNA, AK 99669
(907) 262-8597
(907) 262-6516
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MDG848
—
AK
Enumeration date
06/27/2006
Last updated
07/22/2020
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