MEDICARE: THOMAS L MACCHIA 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	49	AK

General Provider Information

NPI Number	:	1912245929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS L MACCHIA PA

Provider Business Mailing Address
First Line	:	1540 MEDFRA ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99501-5519
Country	:	US
Telephone Number	:	907-258-5640
Fax Number	:

Provider Business Practice Location Address
First Line	:	7999 JEWEL LAKE RD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99502-4251
Country	:	US
Telephone Number	:	907-770-2380
Fax Number	:	907-770-2341

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

Provider Enumeration Date	:	01/25/2013
Last Update Date	:	01/25/2013

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Directions to “ THOMAS L MACCHIA PA” Practice Location

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