Mat-Su Valley III LLC

NPI #1366752560 in Palmer, Alaska

Provider Information

NPI Number: 1366752560
Entity Type: Organization
Organization Name: Mat-Su Valley III LLC
Primary Specialty: Internal Medicine
Enumeration Date: Oct 21, 2010
Last Updated: Nov 19, 2024

Practice Location

Address: 2500 S WOODWORTH LOOP
City: Palmer
State: Alaska
ZIP Code: 99645-8984
Phone: (907) 861-6565

Authorized Official

Name: KRISTY MUSIC
Title: DIRECTOR, PROVIDER ENROLLMENT
Phone: (615) 465-7377

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Internal Medicine - Cardiovascular Disease — Cardiovascular Disease	207RC0000X
Internal Medicine - Gastroenterology — Gastroenterology	207RG0100X
Internal Medicine - Interventional Cardiology — Interventional Cardiology	207RI0011X
Obstetrics & Gynecology	207V00000X
Physician Assistant	363A00000X
Nurse Practitioner - Family — Family	363LF0000X
Internal Medicine	207R00000X	Primary

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