PAUL L HENDRICKSON MD NPI 1679514210

NPI Information

NPI: 1679514210
Provider Name: PAUL L HENDRICKSON, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
1027 WASHINGTON AVE
DETROIT LAKES, MN
ZIP 56501
Phone: (218) 847-5611
Get Directions

Paul L Hendrickson, MD is a family medicine in Detroit Lakes, MN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Paul L Hendrickson, MD NPI is 1679514210. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1027 WASHINGTON AVE
DETROIT LAKES, MN
ZIP 56501-409
Phone: (218) 847-5611
Fax: (218) 847-0881

The enumeration date for this NPI number is 6/8/2006 and was last updated on 11/21/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		032152	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	10440	OTHER	MINNESOTA	NDBS #
2	0106054	OTHER	MINNESOTA	MEDICA #
3	0106545	OTHER	MINNESOTA	MEDICA #
4	080041905	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA	RR MEDICARE #
5	E25357	MEDICARE UPIN	MINNESOTA
6	DA9031015654	OTHER	MINNESOTA	PREFERRED ONE #
7	901108	OTHER	MINNESOTA	AMERICA'S PPO/ARAZ #
8	28232HE	OTHER	MINNESOTA	MNBS #
9	089004398	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA	MN MEDICARE #
10	HP19489	OTHER	MINNESOTA	HEALTHPARTNERS #
11	108034	OTHER	MINNESOTA	UCARE #
12	MN1000020	OTHER	MINNESOTA	LHS/BANNERHEALTH #
13	2223	OTHER	MINNESOTA	SIOUX VALLEY #
14	16005	MEDICAID	MINNESOTA
15	300793600	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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