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General NPI Number Information
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NPI Number | 1003339334
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Entity Type | Organization
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Legal Business Name | KENAI PENINSULA HEALTH SYSTEM LLC URGENT CARE OF SOLDOTNA
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 10/05/2017
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Provider Practice Location Address
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Address Line | 44604 STERLING HWY STE D
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City | SOLDOTNA
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State | AK
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Zip | 99669-7962
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Country | US
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Telephone | 406-407-3126
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Fax |
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Provider Business Mailing Address
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Address Line | 44604 STERLING HWY STE D
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City | SOLDOTNA
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State | AK
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Zip | 99669-7962
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | JEOFFREY W LANFEAR
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Credential | N.P.
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Telephone | 406-407-3126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 1053820
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License Number State | AK
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