Provider Demographics
NPI:1114091527
Name:LEFGREN, HELYN M (MD)
Entity Type:Individual
Prefix:
First Name:HELYN
Middle Name:M
Last Name:LEFGREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60743
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99705
Mailing Address - Country:US
Mailing Address - Phone:907-488-4433
Mailing Address - Fax:
Practice Address - Street 1:145 SANTA CLAUS LANE
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705
Practice Address - Country:US
Practice Address - Phone:907-488-4433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1471207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALMD1471Medicaid
ALMD1471Medicaid
E67928Medicare UPIN