Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 2006028765 | MO |
Y | 207YS0123X | Facial Plastic Surgeon | MEDS7503 | AK |
NPI | 1043340185 |
---|---|
Provider Name | Dr. Christina Bray Magill |
First Address | Wasilla, AK 99654-7273 |
Second Address | Wasilla, AK 99654-7273 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 15/06/2020 |