Provider Demographics
NPI:1912095605
Name:KUFEL, MARK C (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:C
Last Name:KUFEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W NORTHERN LIGHTS BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3877
Mailing Address - Country:US
Mailing Address - Phone:907-569-1123
Mailing Address - Fax:907-569-1180
Practice Address - Street 1:400 W NORTHERN LIGHTS BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3877
Practice Address - Country:US
Practice Address - Phone:907-569-1123
Practice Address - Fax:907-569-1180
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK284111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKU50046Medicare UPIN
AKK160386Medicare ID - Type UnspecifiedMEDICARE