Dr. Dennis Lynn Mickleson, M.D.
Family Medicine, Adult Medicine in Palmer, AK. Individual provider (NPI-1).
NPI number1619388600
StatusActive
Last updated in NPPESMay 13, 2014
Details
- NPI
- 1619388600
- Entity type
- Individual (NPI-1)
- Name
- Dr. Dennis Lynn Mickleson
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 13, 2014
- Last updated
- May 13, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QA0505X | Family Medicine, Adult Medicine | AA2638 | AK | Yes |
Practice location
8220 Gold Bullion BlvdPalmer, AK 99645
Phone 907-745-0832 · Fax 907-745-0832
Mailing address
Po Box 2863Palmer, AK 99645-2863
Phone 907-745-0832 · Fax 907-745-0832
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