Family Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1454 Issued in AK

Legal business name

FAMILY MEDICAL CLINIC

Doing business as

Lavern Davidhizar

Practice address

206 W Rockwell Ave
Suite 100
Soldotna, AK 99669-7411

Phone

(907) 262-7566

Fax

(907) 262-0809

NPI assigned

Oct 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lavern R Davidhizar, DO

Title

President

Phone

(907) 262-7566

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Lavern Davidhizar Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351468800000",
    "number": "1073701421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 W ROCKWELL AVE",
            "address_2": "SUITE 100",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697411",
            "telephone_number": "907-262-7566",
            "fax_number": "907-262-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W ROCKWELL AVE",
            "address_2": "SUITE 100",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697411",
            "telephone_number": "907-262-7566",
            "fax_number": "907-262-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2012-10-29",
        "status": "A",
        "authorized_official_last_name": "DAVIDHIZAR",
        "authorized_official_first_name": "LAVERN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-262-7566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "AK",
            "license": "4221",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AK",
            "license": "4221",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "1454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD1454",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lavern Davidhizar",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Justin P Evans, M.D.
• Matthew Evans, MD
• Karla Evarts
• Elizabeth S Eveland
• Malcolm John Fadden
• Family Way Home Birth Services, Inc.
• Christine Marie Fanelli, APRN
• Alannah Farlow, RBT
• Nancy Farrington, RN, BSN, MSN
• Amanda Faulkner

• Family Medicine Physician in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.