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Organization

KA BLOOMQUIST RG BAKEWELL OD PA

Active
Other names
Eye Associates of Alexandria
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN D HOVEN OD (PRESIDENT)
(320) 763-4321
Entity
Organization

Contact information

Practice address
120 12TH AVE E, ALEXANDRIA, MN 56308
(320) 763-4321
(320) 763-6921
Mailing address
PO BOX 789, 120 12TH AVE E, ALEXANDRIA, MN 56308
(320) 763-4321
(320) 763-6921

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
030701053
PRIMEWEST
01
0373300001
DME
01
121754
U CARE
01
2115931
MEDICA
01
4C196BL
BLUE CROSS
01
5982
HEALTH PARTNERS
01
61045BL
BLUE CROSS
01
942812700
MEDICAL ASSISTANCE
01
96477
PREFERRED ONE
01
CG3570
RR MEDICARE
Enumeration date
10/27/2006
Last updated
09/12/2011
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