Jaconette, Andrew Richard

Jaconette, Andrew Richard is an sole proprietor health care provider with primary practice located at 851 E Westpoint Dr Suite 203, Wasilla AK 99654-7191. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Jaconette, Andrew Richard can be contacted via phone (907) 373-7934.

Contact Information

Primary practice address
851 E Westpoint Dr Suite 203 Wasilla AK 99654-7191
Phone: (907) 373-7934
Fax: (907) 677-6999
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 5328 Alaska
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 5328 Alaska

Profile Details

NPI number 1487778304
LBN Legal business name Jaconette, Andrew Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 17th, 2007
Last updated Mar 20th, 2017 - about 7 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 1487778304 NPPES
Alaska MEDICAID 1016497

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