IVANHOE CLINIC NPI 1316162308

NPI Information

NPI: 1316162308
Provider Name: IVANHOE CLINIC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
121 W SAXON ST
IVANHOE, MN
ZIP 56142
Phone: (507) 694-1232
Get Directions

IVANHOE CLINIC is a primary care clinic center in Ivanhoe, MN. IVANHOE CLINIC NPI is 1316162308. The provider is registered as an organization entity type.

The provider's business location address is:

121 W SAXON ST
IVANHOE, MN
ZIP 56142-504
Phone: (507) 694-1232
Fax: (507) 694-1171

The provider's authorized official is Richard Dean Mulder .
The authorized official title is Owner and has the following contact phone number (507) 694-1232.

The enumeration date for this NPI number is 4/16/2007 and was last updated on 8/1/2008.

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	261QP2300X	Clinic/Center	Primary Care	18873	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	D48832	MEDICARE UPIN	MINNESOTA
2	46119IV	OTHER	MINNESOTA	BLUE CROSS BLUE SHIELD
3	158210100	MEDICAID	MINNESOTA
4	C07207	MEDICARE ID-TYPE UNSPECIFIED	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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