Provider Demographics
NPI:1831361724
Name:WILLIAM MORRIS PALMER MD PC
Entity type:Organization
Organization Name:WILLIAM MORRIS PALMER MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:907-586-1895
Mailing Address - Street 1:3268 HOSPITAL DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7800
Mailing Address - Country:US
Mailing Address - Phone:907-586-1895
Mailing Address - Fax:907-568-2595
Practice Address - Street 1:3268 HOSPITAL DR
Practice Address - Street 2:SUITE E
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7800
Practice Address - Country:US
Practice Address - Phone:907-586-1895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK1092208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD1092Medicaid
AKMDG572Medicaid
AK1306856976OtherINDIVIDUAL NPI
AKC97199Medicare UPIN