Provider Demographics
NPI:1659560704
Name:JOHN KREHLIK, MD, INC
Entity Type:Organization
Organization Name:JOHN KREHLIK, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KREHLIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-789-6766
Mailing Address - Street 1:9309 GLACIER HWY
Mailing Address - Street 2:B301
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9306
Mailing Address - Country:US
Mailing Address - Phone:907-789-6766
Mailing Address - Fax:907-789-6703
Practice Address - Street 1:9309 GLACIER HWY
Practice Address - Street 2:B301
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-9306
Practice Address - Country:US
Practice Address - Phone:907-789-6766
Practice Address - Fax:907-789-6703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3059207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty