Organization
REGINA S CHENNAULT MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REGINA S CHENNAULT MD (MD)
(907) 264-1204
Entity
Organization
Contact information
Practice address
2841 DEBARR ROAD, SUITE 42, ANCHORAGE, AK 99508-2956
(907) 264-1204
(907) 264-1995
Mailing address
2841 DEBARR ROAD, SUITE 42, ANCHORAGE, AK 99508-2956
(907) 264-1204
(907) 264-1995
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5170
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD8085
—
AK
Enumeration date
12/11/2007
Last updated
12/11/2007
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