Mickelson, Charles Chris

Mickelson, Charles Chris is an individual health care provider with primary practice located at 250 Hospital Pl , Soldotna AK 99669-7559. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Mickelson, Charles Chris can be contacted via phone (907) 714-4444.

Contact Information

Primary practice address
250 Hospital Pl Soldotna AK 99669-7559
Phone: (907) 714-4444
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 3497 Alaska

Profile Details

NPI number 1447275318
LBN Legal business name Mickelson, Charles Chris
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Jul 10th, 2020 - about 4 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 1447275318 NPPES
Alaska MEDICAID MD3497
Alaska Other P00464956

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