Mat-Su Ear, Nose, Throat & Facial Plastics, Inc.

NPI #1912010687 in Palmer, Alaska

Provider Information

NPI Number: 1912010687
Entity Type: Organization
Organization Name: Mat-Su Ear, Nose, Throat & Facial Plastics, Inc.
Primary Specialty: Specialist
Enumeration Date: Aug 16, 2006
Last Updated: Dec 27, 2017

Practice Location

Address: 2490 SOUTH WOODWORTH LOOP
Address 2: 201
City: Palmer
State: Alaska
ZIP Code: 99645
Phone: (907) 745-9200

Authorized Official

Name: ANDREW RICHARD PULLIAM, MD
Title: PRESIDENT
Phone: (907) 745-9200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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