Individual
KAYSIE LYNN BANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Mailing address
720 WASHINGTON AVE SE, MINNEAPOLIS, MN 55414-2924
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
46661
MN
Other
Enumeration date
02/14/2007
Last updated
06/30/2017
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