Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. DENNIS LYNN MICKLESON, M.D.
Active Sole ProprietorDR. DENNIS LYNN MICKLESON, M.D. is a Adolescent Medicine healthcare provider located in PALMER, Alaska. NPI 1619388600 is currently active in the NPPES registry. Verify at CMS.
Adolescent Medicine · PALMER, AK
Registration Details
- NPI Number
- 1619388600
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 13, 2014 (12.066209340493 yrs)
- Last Updated
- May 13, 2014
- License
-
AA2638 (AK)
- Sole Proprietor
- Yes
Practice Information
- Address
-
8220 GOLD BULLION BLVDPALMER, AK, 99645Browse AK providers · Browse ZIP 99645
- Phone
- 9077450832
- Fax
- 9077450832
- Primary Specialty
-
Adolescent Medicine
207QA0505X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.