Provider Demographics
NPI:1760516405
Name:ROBERT A BREFFEILH MD & GORDON R PREECS MD
Entity Type:Organization
Organization Name:ROBERT A BREFFEILH MD & GORDON R PREECS MD
Other - Org Name:TONGASS REGIONAL EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:R
Authorized Official - Last Name:PREECS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-586-2700
Mailing Address - Street 1:3268 HOSPITAL DR STE A
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7800
Mailing Address - Country:US
Mailing Address - Phone:907-586-2700
Mailing Address - Fax:
Practice Address - Street 1:3268 HOSPITAL DR STE A
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7800
Practice Address - Country:US
Practice Address - Phone:907-586-2700
Practice Address - Fax:907-586-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD2430Medicaid
AKMD2398Medicaid
AKE21884Medicare UPIN
AK0000WCJNHMedicare ID - Type UnspecifiedGROUP
AK00WCJNHAMedicare ID - Type UnspecifiedGORDON R. PREECS MD
AKMD2398Medicaid
AK00WCJNHBMedicare ID - Type UnspecifiedROBERT A BREFFEIL MD