NPI 1407304017

McKinley Sports Medicine, LLC

Organisation Sports Medicine (Family Medicine) Physician Fairbanks, AK

Practice location

Address: 3745 Geist Rd, Fairbanks, AK 99709-3554
Phone: (907) 456-3341
Fax: (907) 456-3443

Authorised official

Name: Jennifer K Malcolm
Title: President
Phone: (907) 456-3341

Registered specialties

Sports Medicine (Family Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207QS0010X Licence 10040231 (AK)

Other Family Medicine providers in Alaska →

Registry record

NPI: 1407304017
Entity type: Organization
NPI issued: 13 Sep 2016
Record last updated: 13 Sep 2016

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.