| St Anthony Optometric Clinic | |
|
2929 Pentagon Dr St Anthony MN 55418-3208 | |
| (612) 781-4730 | |
| (612) 706-2337 |
| Full Name | St Anthony Optometric Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 2929 Pentagon Dr, St Anthony, Minnesota |
| Authorized Official Name and Position | Todd Jeffrey Hanson (PRESIDENT OWNER) |
| Authorized Official Contact | 6127814730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Anthony Optometric Clinic 2929 Pentagon Dr St Anthony MN 55418-3208 Ph: (612) 781-4730 | St Anthony Optometric Clinic 2929 Pentagon Dr St Anthony MN 55418-3208 Ph: (612) 781-4730 |
| NPI Number | 1205953437 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2163314600 |
|---|---|
| Medicare Enrollment ID | O20040329000508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205953437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 2443 (Minnesota) | Primary |
| Provider Name | Todd J Hanson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740344894 PECOS PAC ID: 1658263199 Enrollment ID: I20040330001170 |
| Provider Name | Anthony R Doffin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1366520538 PECOS PAC ID: 1759338585 Enrollment ID: I20050405000167 |
| Provider Name | Kari J Burgard |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164713392 PECOS PAC ID: 1254588387 Enrollment ID: I20130731000372 |
Silver Lake Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 39th Ave Ne, St Anthony, MN 55421 Phone: 612-706-2900 Fax: 612-706-2901 |