Provider Demographics
NPI:1023076007
Name:LECHEMINANT, GARTH W (MD)
Entity type:Individual
Prefix:DR
First Name:GARTH
Middle Name:W
Last Name:LECHEMINANT
Suffix:
Gender:M
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 876774
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-6774
Mailing Address - Country:US
Mailing Address - Phone:907-745-8100
Mailing Address - Fax:907-746-2655
Practice Address - Street 1:2490 S WOODWORTH LOOP STE 450
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-7407
Practice Address - Country:US
Practice Address - Phone:907-745-9401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5147208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD5147Medicaid
AKK160812Medicare PIN
AKI23556Medicare UPIN