| Creekside Family Health Clinic Inc | |
|
320 Bawden St Suite #313 Ketchikan AK 99901-6573 | |
| (907) 220-9982 | |
| (907) 220-9972 |
| Full Name | Creekside Family Health Clinic Inc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 320 Bawden St, Ketchikan, Alaska |
| Authorized Official Name and Position | John Hill (OFFICE MANAGER) |
| Authorized Official Contact | 9072209982 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Family Health Clinic Inc 3521 Lomita Blvd Suite #103 Torrance CA 90505-5039 Ph: (310) 534-9131 | Creekside Family Health Clinic Inc 320 Bawden St Suite #313 Ketchikan AK 99901-6573 Ph: (907) 220-9982 |
| NPI Number | 1477847184 |
|---|---|
| Provider Enumeration Date | 05/31/2011 |
| Last Update Date | 11/13/2012 |
| Medicare PECOS PAC ID | 4385895713 |
|---|---|
| Medicare Enrollment ID | O20121113000389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477847184 | NPI | - | NPPES |
| MPG0359 | Medicaid | AK | |
| NP0504 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Leslie Locklear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336469469 PECOS PAC ID: 2769678598 Enrollment ID: I20160427000750 |
| Provider Name | Shawna Strouth-shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205335809 PECOS PAC ID: 0840530879 Enrollment ID: I20190328002690 |
Kic Tribal Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2960 Tongass Ave, Ketchikan, AK 99901 Phone: 907-228-4900 Fax: 907-228-4905 | |
Harmony Health Clinic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21 Jefferson Way Ste 203, Ketchikan, AK 99901 Phone: 907-225-6699 Fax: 907-247-1199 | |
Northway Family Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Carlanna Lake Rd Ste 201, Ketchikan, AK 99901 Phone: 907-225-4325 Fax: 907-225-4326 | |
First City Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 212 Carlanna Lake Rd Ste 201, Box 6755, Ketchikan, AK 99901 Phone: 907-247-3301 Fax: 907-247-3306 | |
Kic Tribal Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2960 Tongass Ave, Ketchikan, AK 99901 Phone: 907-228-4900 | |
Island Medical Services Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3526 Tongass Ave, Ketchikan, AK 99901 Phone: 907-228-3075 |