Glaeser, Kenneth Douglas

Glaeser, Kenneth Douglas is an individual health care provider with primary practice located at 1650 Cowles St , Fairbanks AK 99701-5925. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Glaeser, Kenneth Douglas can be contacted via phone (907) 458-5555.

Contact Information

Primary practice address
1650 Cowles St Fairbanks AK 99701-5925
Phone: (907) 458-5555
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 5060 Alaska

Profile Details

NPI number 1447247929
LBN Legal business name Glaeser, Kenneth Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Jul 28th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447247929 NPPES
Alaska MEDICAID MD80611

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