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MR. MATTHEW WILLARD PA-C

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1336360304

Individual Registrant:
MR. MATTHEW  WILLARD PA-C
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1 TOKSOOK BAY SUB-REGIONAL CLINIC  TOKSOOK BAY, AK 99637 US
Tel: 907-543-6300  Fax: --

Contact information for business:
PO BOX 37028  TOKSOOK BAY, AK 99637 US
Tel: 907-427-3500  Fax: 907-427-3526

Registration Information:
NPI: 1336360304
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
AK629

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MDA0196AK05




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