| Organization Name: | EAGLE RIVER PRIMARY CARE |
| NPI Number: | 1235319450 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JENNIFER J OXFORD (REGISTERED AGENT) |
| Mailing Address: | 11462 Business Blvd Eagle River |
| State: | AK US |
| Postal Code: | 995777721 |
| Phone Number: | 9076940770 |
| Fax Number: | 9076941378 |
| NPI Enumeration Date: | 11/05/2007 |
| NPI Last Update Date: | 06/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA448 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |