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Organization
HEARTLAND ORTHOPEDIC SPECIALISTS
Active
Organization
HEARTLAND ORTHOPEDIC SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S DOYLE (ADMINISTRATOR)
(320) 762-1144
Entity
Organization
Contact information
Practice address
111 17TH AVE E, SUITE 101, ALEXANDRIA, MN 56308-3703
(320) 762-1144
(320) 762-1935
Mailing address
111 17TH AVE E, SUITE 101, ALEXANDRIA, MN 56308-3734
(320) 762-1144
(320) 762-1935
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
2255A2300X
Athletic Trainer
—
NULL
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104667
UCARE
—
01
—
30701054
PRIMEWEST
—
01
—
564
LICENSE
MN
01
—
61006AL
BC/BS
—
05
—
888210000
—
MN
01
—
CP4310
TRAVELERS MEDICARE
MN
Enumeration date
09/22/2006
Last updated
01/27/2011
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