SAMUEL A MCCONKEY III MD PC NPI 1578601340

Ophthalmology in Fairbanks, AK

Organization Ophthalmology

About SAMUEL A MCCONKEY III MD PC

Samuel A Mcconkey Iii Md Pc is a provider in Fairbanks, AK. The NPI number assigned to this provider is 1578601340. The practitioner's primary taxonomy code is Ophthalmology (207W00000X). The provider is registered as an organization and their NPI record was last updated 9 years ago. Samuel A Mcconkey Iii Md Pc operates as a single speciality business group with one or more individual providers who practice the same area of specialization.

NPI

1578601340

Provider NameSAMUEL A MCCONKEY III MD PC
Provider Location Address1521 STACIA ST FAIRBANKS, AK 99701
Provider Mailing Address315 ILLINOIS ST FAIRBANKS, AK 99701
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date02-02-2007
Last Update Date12-09-2010

Primary Taxonomy

Taxonomy Code207W00000X
ClassificationOphthalmology
TypeAllopathic & Osteopathic Physicians
License No.849
License StateAK
Taxonomy DescriptionAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Business Address

SAMUEL A MCCONKEY III MD PC
1521 STACIA ST
FAIRBANKS, AK
ZIP 99701
Phone: (907) 456-4822

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Mailing Address

SAMUEL A MCCONKEY III MD PC
315 ILLINOIS ST
FAIRBANKS, AK
ZIP 99701
Phone: (907) 456-7767
Fax: (907) 456-8050

Authorized Official

Authorized Official Name SAMUEL A MCCONKEY MD
Authorized Official TitleOWNER
Authorized Official Phone(907) 456-7767

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
C97169MEDICARE UPIN (02)AK
C97169MEDICARE UPIN (02)AZ
152587MEDICARE ID-TYPE UNSPECIFIED (04)AK
72858MEDICARE ID-TYPE UNSPECIFIED (04)AZ
MD0849MEDICAID (05)AK

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1093874182 AUGUSTA ANN PLASSMANN KING O.D.
Individual
Optometrist1521 STACIA ST UNIT B
FAIRBANKS, AK 99701
(907) 456-4822
1104154079GOLDEN NORTH OPTICS, INC
Organization
Technician/Technologist (Optician)1521 STACIA ST
FAIRBANKS, AK 99701
(907) 456-4822
1871886176MAYGREN FAMILY EYE CARE
Organization
Optometrist1521 STACIA ST
FAIRBANKS, AK 99701
(907) 456-4822

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.

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