Elias N Hydrick, D.O.
Individual provider Active NPI Family Medicine Physician · Eielson Afb, AK
NPI 1629419650 · NPPES record last updated Oct 16, 2024
Key facts
- NPI
- 1629419650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0102204022 (VA)
- Practice address
- 2630 Central Ave
Eielson Afb, AK 99702-2301 - Phone
- (907) 377-6526
- NPI assigned
- Jul 6, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102204022 | VA | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0102204022 | VA | Yes |
Addresses
Primary practice location
2630 Central Ave
Eielson Afb, AK 99702-2301
Mailing address
2630 Central Ave
Eielson Afb, AK 99702-2301
Phone (907) 377-6526
Other providers in Eielson Afb, AK
- Nathan Hamilton
- Whitney Neal Hasbrouck
- Kaleb Hatfield
- Charles W. Houlding
- Dennis Huff
- Nichole Kilinc
- Hannah Laurel Kopchinski
- Matthew Robert Kramer
- Zachery Lavender
- Danielle A Lawson
All providers in Eielson Afb, AK · Family Medicine Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.