NPI 1780142042

Odyssey Family Practice

Organisation Family Medicine Physician Kenai, AK

Practice location

Address: 11595 Kenai Spur Highway, Kenai, AK 99611
Phone: (907) 313-4569
Fax: (907) 313-4939
Mailing address: PO Box 922, Kasilof, AK 99610-0922

Authorised official

Name: Jared Lee Wallace
Title: Owner
Phone: (907) 313-4569

Registered specialties (3)

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Alaska →

Occupational Medicine Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QX0100X

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Clinical Medical Laboratory

Laboratories Taxonomy 291U00000X

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Registry record

NPI: 1780142042
Entity type: Organization
NPI issued: 6 Mar 2019
Record last updated: 1 Dec 2025

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.