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General NPI Number Information
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NPI Number | 1326538331
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Entity Type | Individual
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Provider Name | ANTHONY PORCARELLI MARKUSON MD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 3959 BEN WALTERS LN
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City | HOMER
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State | AK
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Zip | 99603-7707
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Country | US
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Telephone | 907-235-3436
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Fax |
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Provider Business Mailing Address
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Address Line | 700 CHIEF EDDIE HOFFMAN HIGHWAY
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City | BETHEL
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State | AK
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Zip | 99559
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MRM-1731
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License Number State | ID
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