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NPI 1831162130

NPI 1831162130 : BOBBIE JO BEHRENS M.D. : SOLDOTNA, AK

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General NPI Number Information
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    NPI Number           |    1831162130
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    Entity Type          |    Individual 
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    Provider Name        |    BOBBIE JO BEHRENS M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/08/2006
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    Last Update Date     |    10/29/2007
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Provider Practice Location Address
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    Address Line         |    35670 KENAI SPUR HWY 101B
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    City                 |    SOLDOTNA
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    State                |    AK
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    Zip                  |    99669-7626
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    Country              |    US
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    Telephone            |    907-262-2615
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    Fax                  |    907-262-8842
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Provider Business Mailing Address
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    Address Line         |    35670 KENAI SPUR HWY 101B
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    City                 |    SOLDOTNA
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    State                |    AK
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    Zip                  |    99669-7626
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    Country              |    US
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    Telephone            |    907-262-2615
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    Fax                  |    907-262-8842
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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        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    2471
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    License Number State |    AK
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