NPI 1083715262

Southeast Urology Clinic a PC

Organisation Urology Physician Ketchikan, AK

Practice location

Address: 3100 Tongass Ave, Ketchikan, AK 99901-5746
Phone: (907) 225-1896
Fax: (360) 428-4377
Mailing address: 1311 E Division St, Mount Vernon, WA 98274

Authorised official

Name: Eva M Samtmana
Title: Aministrator
Phone: (360) 424-7991

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 121467 (AK)

Other Urology providers in Alaska →

Registry record

NPI: 1083715262
Entity type: Organization
NPI issued: 26 Sep 2006
Record last updated: 9 Aug 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.