Organization
JESSE ATWOOD MD PEDIATRICS, LLC
Active
Other names
Jesse Atwood MD Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE WILLIAM ATWOOD M.D. (PRESIDENT)
(509) 999-0949
Entity
Organization
Contact information
Practice address
2500 S WOODWORTH LOOP, PALMER, AK 99645-8984
(907) 861-6000
Mailing address
PO BOX 876166, WASILLA, AK 99687-6166
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
7328
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD4770
—
AK
Enumeration date
08/06/2015
Last updated
03/30/2023
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