Individual
DR. DENNIS LYNN MICKLESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8220 GOLD BULLION BLVD, PALMER, AK 99645
(907) 745-0832
(907) 745-0832
Mailing address
PO BOX 2863, PALMER, AK 99645-2863
(907) 745-0832
(907) 745-0832
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
AA2638
AK
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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