Organization
JUNEAU OBSTETRICS AND GYNECOLOGY, P.C.
Active
Other names
Nell Ann Wagoner, M.D., P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS D NEWBURY D.O. (OWNER)
(907) 586-1717
Entity
Organization
Contact information
Practice address
3268 HOSPITAL DR STE B, JUNEAU, AK 99801-7800
(907) 586-1717
(907) 586-2677
Mailing address
3268 HOSPITAL DR STE B, JUNEAU, AK 99801-7800
(907) 586-1717
(907) 586-2677
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
2531
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020712
—
AK
05
—
MD2531
—
AK
Enumeration date
09/28/2006
Last updated
07/29/2017
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