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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