MEDICARE: SHIGONE BEIGHLE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1265838197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIGONE BEIGHLE PA

Provider Business Mailing Address
First Line	:	3521 MOUNTAIN VIEW DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-1111
Country	:	US
Telephone Number	:	907-868-1105
Fax Number	:	844-540-0839

Provider Business Practice Location Address
First Line	:	3521 MOUNTAIN VIEW DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-1111
Country	:	US
Telephone Number	:	907-868-1105
Fax Number	:	844-540-0938

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2014
Last Update Date	:	12/05/2023

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Directions to “ SHIGONE BEIGHLE PA” Practice Location

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