MEDICARE: DR. JOSEPH VINCENT PACE M.D.

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	2084P0800X	Psychiatry Physician	5913	AK

General Provider Information

NPI Number	:	1982693586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH VINCENT PACE M.D.

Provider Business Mailing Address
First Line	:	25850 DENAINA DR
Second Line	:
City	:	EAGLE RIVER
State	:	AK
Zip	:	99577-9103
Country	:	US
Telephone Number	:	907-257-4841
Fax Number	:	907-257-6747

Provider Business Practice Location Address
First Line	:	1201 N MULDOON RD
Second Line	:	SBHS
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-6104
Country	:	US
Telephone Number	:	907-257-4841
Fax Number	:	907-257-4842

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

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	10/07/2014

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