Organization
MAT-SU VALLEY III LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY MUSIC (DIRECTOR, PROVIDER ENROLLMENT)
(877) 892-9815
Entity
Organization
Contact information
Practice address
2500 S WOODWORTH LOOP, PALMER, AK 99645-8984
(907) 861-6565
(907) 861-6568
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MPG0314
—
AK
Enumeration date
10/21/2010
Last updated
02/25/2026
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