Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 5147 | AK |
Y | 208600000X | Surgeon | 5147 | AK |
NPI | 1023076007 |
---|---|
Provider Name | Dr. Garth W Lecheminant |
First Address | Wasilla, AK 99687-6774 |
Second Address | Palmer, AK 99645-7407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 15/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I23556 | (02) | AK |
MD5147 | (05) | AK |