Provider Demographics
NPI:1639271323
Name:CHENA OBSTETRICS & GYNECOLOGY PC
Entity type:Organization
Organization Name:CHENA OBSTETRICS & GYNECOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EILUNED
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-456-8191
Mailing Address - Street 1:1919 LATHROP ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-5930
Mailing Address - Country:US
Mailing Address - Phone:907-456-8191
Mailing Address - Fax:
Practice Address - Street 1:1919 LATHROP ST
Practice Address - Street 2:SUITE 222
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-5930
Practice Address - Country:US
Practice Address - Phone:907-456-8191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK160937Medicare PIN