Eagle River Dermatology Inc
NPI 1750880654ActiveOrganization· Dermatology· Eagle River, AK
Dermatology in Eagle River, Alaska, registered in NPPES in February 2018. The authorized official on file is Lindsay Jay Proctor, M.A, Office Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1750880654 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 6, 2018 |
| Last updated in NPPES | Feb 6, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | AK503 | AK |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AK) |
|---|