| Essentia Health St. Mary's - Lake Park Clinic | |
|
1005 1st St Lake Park MN 56554-4311 | |
| (218) 238-5901 | |
| Not Available |
| Full Name | Essentia Health St. Mary's - Lake Park Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1005 1st St, Lake Park, Minnesota |
| Authorized Official Name and Position | Alan Hurley (COO) |
| Authorized Official Contact | 7013647667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Essentia Health St. Mary's - Lake Park Clinic 1027 Washington Ave Detroit Lakes MN 56501-3409 Ph: (218) 238-5901 | Essentia Health St. Mary's - Lake Park Clinic 1005 1st St Lake Park MN 56554-4311 Ph: (218) 238-5901 |
| NPI Number | 1548604309 |
|---|---|
| Provider Enumeration Date | 04/24/2013 |
| Last Update Date | 03/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548604309 | NPI | - | NPPES |
| 892442000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Dakota Clinic, Ltd. - Lake Park Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2049 2nd St, Lake Park, MN 56554 Phone: 218-238-5901 Fax: 218-844-2444 |