| Polaris Healthcare | |
|
25 Jefferson Way Suite 102b Ketchikan AK 99901-5953 | |
| (907) 247-7827 | |
| (973) 215-2052 |
| Full Name | Polaris Healthcare |
|---|---|
| Speciality | Internal Medicine |
| Location | 25 Jefferson Way, Ketchikan, Alaska |
| Authorized Official Name and Position | Kevin A Hall (OWNER / PHYSICIAN) |
| Authorized Official Contact | 9072477827 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Polaris Healthcare 748 Miller Ridge Rd Ketchikan AK 99901 Ph: (201) 259-0289 | Polaris Healthcare 25 Jefferson Way Suite 102b Ketchikan AK 99901-5953 Ph: (907) 247-7827 |
| NPI Number | 1770131930 |
|---|---|
| Provider Enumeration Date | 08/30/2019 |
| Last Update Date | 08/27/2020 |
| Medicare PECOS PAC ID | 1052743705 |
|---|---|
| Medicare Enrollment ID | O20191118002337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770131930 | NPI | - | NPPES |
| 1700612 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kevin Arthur Hall |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1467708271 PECOS PAC ID: 3971732538 Enrollment ID: I20191119000061 |
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