Dr Glenn Leroy Detlefsen, MD is a
Family Medicine physician based in Rosemount, Minnesota. Dr Glenn Leroy Detlefsen is licensed to practice in Minnesota (license number 26214) and his current practice location is 15120 Chippendale Ave W, Rosemount, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(651) 423-4114.
NPI number for Dr Glenn Leroy Detlefsen is 1013052554 and his current mailing address is 15120 Chippendale Ave W, Rosemount, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1013052554.
Physician's Profile
Full Name | Dr Glenn Leroy Detlefsen |
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Gender | Male |
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Speciality | Family Medicine |
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Location | 15120 Chippendale Ave W, Rosemount, Minnesota |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1013052554
- Provider Enumeration Date: 02/21/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Glenn Leroy Detlefsen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1013052554 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 26214 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Glenn Leroy Detlefsen is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Glenn Leroy Detlefsen, MD 15120 Chippendale Ave W, Rosemount, MN 55068-1796 Ph: (651) 423-4114 | Dr Glenn Leroy Detlefsen, MD 15120 Chippendale Ave W, Rosemount, MN 55068-1796 Ph: (651) 423-4114 |
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