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General NPI Number Information
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NPI Number | 1164358529
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Entity Type | Organization
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Legal Business Name | SOUTH PENINSULA HOSPITAL KENAI CLINIC
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 220 SPUR VIEW DR
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City | KENAI
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State | AK
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Zip | 99611-6880
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Country | US
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Telephone | 907-235-8101
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Fax |
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Provider Business Mailing Address
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Address Line | 4300 BARTLETT ST
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City | HOMER
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State | AK
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Zip | 99603-7000
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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 | CEO
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Name | RYAN K SMITH
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Credential |
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Telephone | 907-235-0241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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