Organization
GLACIER GENERAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SLYVIA MCCORMICK (MEMBER)
(907) 374-8914
Entity
Organization
Contact information
Practice address
3419 AIRPORT WAY STE B, FAIRBANKS, AK 99709-4761
(907) 374-8914
(907) 374-8915
Mailing address
3419 AIRPORT WAY STE B, FAIRBANKS, AK 99709-4761
(907) 374-8914
(907) 374-8915
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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