Southeast Urology Clinic a PC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

121467 Issued in AK

Legal business name

SOUTHEAST UROLOGY CLINIC A PC

Practice address

3100 Tongass Ave
Ketchikan, AK 99901-5746

Phone

(907) 225-1896

Fax

(360) 428-4377

NPI assigned

Sep 26, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Eva M Samtmana

Title

Aministrator

Phone

(360) 424-7991

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1083715262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 E DIVISION ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "98274",
            "telephone_number": "360-424-7991",
            "fax_number": "360-424-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 TONGASS AVE",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015746",
            "telephone_number": "907-225-1896",
            "fax_number": "360-428-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST UROLOGY CLINIC A PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "SAMTMANA",
        "authorized_official_first_name": "EVA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AMINISTRATOR",
        "authorized_official_telephone_number": "360-424-7991",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "AK",
            "license": "121467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0126",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Esther Soh, PHARMD
• Lindsay Sonnier, HS3
• Southeast Alaska Prosthetics and Orthotics LLC
• Southeast Alaska Regional Health Consortium
• Southeast Alaska Regional Health Constortium
• Spa Ketchikan LLC
• Naomi Spar
• Keenan Spencer
• Karen Stafford, MSPA, CCC-SLP
• Cindy Starr, SLP

• Urology Physician in Ketchikan, AK
• Providers in Ketchikan, AK by specialty
• Urology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.