Individual
MATTHEW LOUDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3331 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7294
(907) 357-2332
(907) 357-2344
Mailing address
3331 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7294
(907) 357-2332
(907) 357-2344
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PADA1257
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PADA 1257
STATE OF ALASKA PERMANENT LICENSE
AK
Enumeration date
02/02/2015
Last updated
02/21/2016
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