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General NPI Number Information
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NPI Number | 1770439549
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Entity Type | Organization
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Legal Business Name | GOLDEN HEART MEDICAL, LLC
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Dates
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Enumeration Date | 03/05/2026
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 1626 30TH AVE SUITE 201
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City | FAIRBANKS
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State | AK
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Zip | 99701-5910
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Country | US
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Telephone | 678-986-6371
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Fax |
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Provider Business Mailing Address
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Address Line | 1626 30TH AVE SUITE 201
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City | FAIRBANKS
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State | AK
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Zip | 99701-5910
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Country | US
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Telephone | 678-986-6371
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Fax |
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Authorized Official
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Title or Position | CLINICAL MANAGER
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Name | WENDY P BROPHY
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Credential |
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Telephone | 678-986-6371
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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 |
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License Number State |
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