Provider Demographics
NPI:1588702096
Name:TRUE NORTH MEDICINE LLC
Entity type:Organization
Organization Name:TRUE NORTH MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:SKALA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:907-696-8783
Mailing Address - Street 1:PO BOX 772449
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577
Mailing Address - Country:US
Mailing Address - Phone:907-696-8783
Mailing Address - Fax:907-696-8738
Practice Address - Street 1:11431 BUISNESS BLVD
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577
Practice Address - Country:US
Practice Address - Phone:907-696-8783
Practice Address - Fax:907-696-8738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4994207Q00000X
AK4995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty