Odyssey Family Practice

NPI #1780142042 in Kenai, Alaska

Provider Information

NPI Number: 1780142042
Entity Type: Organization
Organization Name: Odyssey Family Practice
Primary Specialty: Family Medicine
Enumeration Date: Mar 6, 2019
Last Updated: Dec 1, 2025

Practice Location

Address: 11595 KENAI SPUR HIGHWAY
City: Kenai
State: Alaska
ZIP Code: 99611
Phone: (907) 313-4569

Authorized Official

Name: JARED LEE WALLACE, PA-C
Title: OWNER
Phone: (907) 313-4569

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Occupational Medicine — Occupational Medicine	261QX0100X
Clinical Medical Laboratory	291U00000X
Family Medicine	207Q00000X	Primary

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