MEDICARE: URGENT CARE MEDICAL CLINIC, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	242636	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497781678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URGENT CARE MEDICAL CLINIC, PC

Provider Business Mailing Address
First Line	:	9150 JEWEL LAKE RD STE B
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99502-5337
Country	:	US
Telephone Number	:	907-248-8561
Fax Number	:	907-248-8563

Provider Business Practice Location Address
First Line	:	9150 JEWEL LAKE RD STE B
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99502-5337
Country	:	US
Telephone Number	:	907-248-8561
Fax Number	:	907-248-8563

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	DR. TALMADGE LAYNE CROWE
Credential	:	MD
Telephone Number	:	907-248-8561

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	10/18/2022

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