Jennifer K Malcolm (NPI# 1154583862, PAC ID# 2668753815) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1154583862 |
| PAC ID by PECOS | 2668753815 |
| Professional Enrollment ID | I20161229001331 |
| Full Name | Jennifer K Malcolm |
| Organization Legal Name | MCKINLEY SPORTS MEDICINE LLC |
| Address |
3745 Geist Rd Fairbanks AK 99709-3554 |
| Phone Number | 9074563341 |
| Gender | F |
| Medical School | PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2008 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | SPORTS MEDICINE |
| Group Practice PAC ID | 8123309465 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 020012 | FAIRBANKS MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3745 Geist Rd, Fairbanks, AK 99709-3554 | 9074563341 | MCKINLEY SPORTS MEDICINE LLC |
| Organization Legal Name | MCKINLEY SPORTS MEDICINE LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Benjamin D Johnson | Physician Assistant | Mckinley Sports Medicine LLC | 3745 Geist Rd, Fairbanks, AK 99709-3554 |
| Street Address |
3745 GEIST RD |
| City | FAIRBANKS |
| State | AK |
| Zip | 99709-3554 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ambria M Ptacek | Physician Assistant | Mckinley Orthopedic and Sportsmedicine, LLC | 3745 Geist Rd, Fairbanks, AK 99709-3554 |
| Neal E Everson | Orthopedic Surgery | Mckinley Orthopedic and Sportsmedicine, LLC | 3745 Geist Rd, Fairbanks, AK 99709-3554 |
| Jennifer A Holt | Physician Assistant | Mckinley Orthopedic and Sportsmedicine, LLC | 3745 Geist Rd, Fairbanks, AK 99709-3554 |
| Benjamin D Johnson | Physician Assistant | Mckinley Sports Medicine LLC | 3745 Geist Rd, Fairbanks, AK 99709-3554 |
| Timothy W Carey | Orthopedic Surgery | Mckinley Orthopedic and Sportsmedicine, LLC | 3745 Geist Rd, Fairbanks, AK 99709-3554 |
| Daniel Ross Johnson | Orthopedic Surgery | Mckinley Orthopedic and Sports Medicine, LLC | 3745 Geist Rd, Fairbanks, AK 99709-3554 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Norman T Lovell | Chiropractic | 570 Riverstone Way, Suite 2, Fairbanks, AK 99709-2940 | |
| Barbara M Keys | Optometry | West Valley Vision Center, Inc | 4169 Geist Rd, Fairbanks, AK 99709-3420 |
| Brannon Heath Mills | Optometry | West Valley Vision Center, Inc | 4169 Geist Rd, Fairbanks, AK 99709-3420 |
| Michael J Mavencamp | Optometry | West Valley Vision Center, Inc | 4169 Geist Rd, Fairbanks, AK 99709-3420 |
| Daniel Charles Costello | Chiropractic | Better World Development LLC | 4001 Geist Rd, Suite 12, Fairbanks, AK 99709-3569 |
| Lindsay M Costello | Physical Therapy | Better World Development LLC | 4001 Geist Rd, Suite 12, Fairbanks, AK 99709-3569 |
| Alfred D Deramus | Ophthalmology | 4001 Geist Rd, Suite 9, Fairbanks, AK 99709-3569 | |
| Joshua Costello | Chiropractic | Better World Development LLC | 4001 Geist Rd, Suite 12, Fairbanks, AK 99709-3569 |
| Susana Joy Donofry | Nurse Practitioner | 565 University Ave, Suite 1, Fairbanks, AK 99709-3687 | |
| John M Worrall | Psychologist, Clinical | 565 University Ave, Suite 4, Fairbanks, AK 99709-3688 | |
| Find all physicians in zip 99709 | |||
| City | FAIRBANKS |
| Zip Code | 99709 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | FAIRBANKS + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Jennifer K Malcolm.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.