Provider Demographics
NPI:1043403926
Name:S LYNN HORNBEIN
Entity Type:Organization
Organization Name:S LYNN HORNBEIN
Other - Org Name:SUMMIT FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HORNBEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-272-3366
Mailing Address - Street 1:2741 DEBARR RD
Mailing Address - Street 2:SUITE C308
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2953
Mailing Address - Country:US
Mailing Address - Phone:907-272-3366
Mailing Address - Fax:907-272-0269
Practice Address - Street 1:2741 DEBARR RD
Practice Address - Street 2:SUITE C308
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2953
Practice Address - Country:US
Practice Address - Phone:907-272-3366
Practice Address - Fax:907-272-0269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKMD2515207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD2515Medicaid
AKE17968Medicare UPIN