Provider Demographics
NPI:1932151149
Name:PREECS, GORDON R (MD)
Entity type:Individual
Prefix:
First Name:GORDON
Middle Name:R
Last Name:PREECS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15795 GLACIER HWY
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8410
Mailing Address - Country:US
Mailing Address - Phone:907-586-2700
Mailing Address - Fax:907-586-2917
Practice Address - Street 1:3268 HOSPITAL DR
Practice Address - Street 2:STE A
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7808
Practice Address - Country:US
Practice Address - Phone:907-586-2700
Practice Address - Fax:907-586-2917
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AKAA2398207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD2398Medicaid
AKMD2398Medicaid
AKE21884Medicare UPIN