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Individual

MS. JUNE M THOMASSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1606 23RD AVE, FAIRBANKS, AK 99701-6407
(907) 455-4567
(907) 458-1581
Mailing address
1606 23RD AVE, FAIRBANKS, AK 99701-6407
(907) 455-4567
(907) 458-1581

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
657
AK
363A00000X
Physician Assistant
Primary
115
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
K152816
MEDICARE PROVIDER NUMBER
AK
Enumeration date
07/30/2006
Last updated
04/01/2008
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