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Individual

DR. JOHN W. JOOSSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1411 19TH AVE, FAIRBANKS, AK 99701-5902
(907) 456-5803
Mailing address
1411 19TH AVE, FAIRBANKS, AK 99701-5902

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0980
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MD0980
AK
Enumeration date
08/21/2006
Last updated
07/09/2007
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