Organization
EAGLE RIVER DERMATOLOGY INC
Active
Organization
EAGLE RIVER DERMATOLOGY INC
Active
Other names
EAGLE RIVER DERMATOLOGY INC
Organization subpart
No
Provider details
NPI number
Authorized official
LINDSAY JAY PROCTOR M.A (OFFICE MANAGER)
(907) 694-3303
Entity
Organization
Contact information
Practice address
16839 PARK PLACE ST, EAGLE RIVER, AK 99577
(907) 694-3303
(907) 694-4773
Mailing address
16839 PARK PLACE ST, EAGLE RIVER, AK 99577
(907) 694-3303
(907) 694-4773
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
AK503
AK
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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