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1335 10th Ave E Shakopee MN 55379-2901 | |
(952) 496-6700 | |
(952) 445-9446 |
Full Name | |
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Speciality | Family Medicine |
Location | 1335 10th Ave E, Shakopee, Minnesota |
Authorized Official Name and Position | John A Rekow (ADMINISTRATOR) |
Authorized Official Contact | 9523610529 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1335 10th Ave East Shakopee MN 55379 Ph: (952) 496-6700 | 1335 10th Ave E Shakopee MN 55379-2901 Ph: (952) 496-6700 |
NPI Number | 1215081468 |
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Provider Enumeration Date | 01/23/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215081468 | NPI | - | NPPES |
51172CH | Other | MN | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 153 (Minnesota) | Primary |
St Francis Regional Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1455 Saint Francis Ave, Shakopee, MN 55379 Phone: 952-428-3000 |