Dr Ken Julian Takekoshi, MD is a
Pathology - Anatomic Pathology & Clinical Pathology physician based in Mendota Heights, Minnesota. Dr Ken Julian Takekoshi is licensed to practice in Michigan (license number 4301076830) and his current practice location is 1766 Trail Rd, Mendota Heights, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(651) 756-0038.
NPI number for Dr Ken Julian Takekoshi is 1841349149 and his current mailing address is 1766 Trail Rd, Mendota Heights, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1841349149.
Physician's Profile
| Full Name | Dr Ken Julian Takekoshi |
|---|
| Gender | Male |
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| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
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| Location | 1766 Trail Rd, Mendota Heights, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1841349149
- Provider Enumeration Date: 01/09/2007
- Last Update Date: 02/13/2017
Medical Identifiers
Medical identifiers for Dr Ken Julian Takekoshi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1841349149 | NPI | - | NPPES |
| 4991871 | Medicaid | MI | |
| 220F160310 | Other | MI | BCBS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 4301076830 (Michigan) | Primary |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 56407-20 (Wisconsin) | Secondary |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 54291 (Minnesota) | Secondary |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 036-114264 (Illinois) | Secondary |
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 Ken Julian Takekoshi 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 Ken Julian Takekoshi, MD
1766 Trail Rd,
Mendota Heights, MN 55118-3730
Ph: (651) 756-0038 | Dr Ken Julian Takekoshi, MD
1766 Trail Rd,
Mendota Heights, MN 55118-3730
Ph: (651) 756-0038 |
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