Provider Demographics
NPI:1598713554
Name:CLANCY, MEGAN J (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:J
Last Name:CLANCY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3500 LATOUCHE STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4248
Mailing Address - Country:US
Mailing Address - Phone:907-561-4362
Mailing Address - Fax:907-563-4498
Practice Address - Street 1:3500 LATOUCHE STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4248
Practice Address - Country:US
Practice Address - Phone:907-561-4362
Practice Address - Fax:907-563-4498
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2024-02-28
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Provider Licenses
StateLicense IDTaxonomies
AK5477207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1015581Medicaid
AK160306Medicare PIN