Provider Demographics
NPI:1255368866
Name:KREHLIK, JOHN MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:KREHLIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 34697
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99803-4697
Mailing Address - Country:US
Mailing Address - Phone:907-743-8987
Mailing Address - Fax:907-743-9887
Practice Address - Street 1:3730 RHONE CIR
Practice Address - Street 2:SUITE 201
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5051
Practice Address - Country:US
Practice Address - Phone:907-743-8987
Practice Address - Fax:907-743-9887
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2013-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK3059207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD3059Medicaid
AK00WCKBDAMedicare PIN
AKMD3059Medicaid