Individual
MR. KENNETH G WAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
131 LINBLAD AVE., GIRDWOOD, AK 99587
(907) 783-2311
Mailing address
PO BOX 651, GIRDWOOD, AK 99587-0651
(907) 783-2311
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
507
AK
Other
Enumeration date
08/15/2008
Last updated
03/19/2014
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