| South Central Family Practice Clinic Pc | |
|
161 N Binkley St Suite 101 Soldotna AK 99669 | |
| (907) 260-7784 | |
| (907) 260-7738 |
| Full Name | South Central Family Practice Clinic Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 161 N Binkley St, Soldotna, Alaska |
| Authorized Official Name and Position | Gladys J Bailon (PRESIDENT) |
| Authorized Official Contact | 9072607784 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Central Family Practice Clinic Pc Po Box 1249 Soldotna AK 99669-1249 Ph: (907) 260-7784 | South Central Family Practice Clinic Pc 161 N Binkley St Suite 101 Soldotna AK 99669 Ph: (907) 260-7784 |
| NPI Number | 1003967753 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 05/18/2018 |
| Medicare PECOS PAC ID | 1355397803 |
|---|---|
| Medicare Enrollment ID | O20050328000652 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003967753 | NPI | - | NPPES |
| 610985200 | Other | AK | OWCP FEDERAL WORKERS COMP |
| 610985200 | Other | AK | OWCP FEDERAL BLACK LUNG |
| GJ520 | Other | AK | PACIFIC SOURCE HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 901044 (Alaska) | Primary |
| Provider Name | Pedro E Perez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700827235 PECOS PAC ID: 0749186880 Enrollment ID: I20040212000822 |
| Provider Name | Gladys J Bailon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467436071 PECOS PAC ID: 3375506736 Enrollment ID: I20041105001031 |
| Provider Name | James Mt Garrity |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1104912807 PECOS PAC ID: 6608882303 Enrollment ID: I20160627000887 |
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