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General NPI Number Information
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NPI Number | 1275983546
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Entity Type | Organization
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Legal Business Name | DENALI ASTHMA & PULMONARY
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Dates
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Enumeration Date | 06/17/2016
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Last Update Date | 06/17/2016
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Provider Practice Location Address
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Address Line | 35670 KENAI SPUR HWY SUITE 103B
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City | SOLDOTNA
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State | AK
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Zip | 99669-7649
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Country | US
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Telephone | 907-260-9515
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Fax | 907-260-9510
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Provider Business Mailing Address
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Address Line | 35670 KENAI SPUR HWY SUITE 103B
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City | SOLDOTNA
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State | AK
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Zip | 99669-7649
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Country | US
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Telephone | 907-260-9515
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Fax | 907-260-9510
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOYCE SHOTWELL
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Credential | MD
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Telephone | 214-824-4412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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