Individual
LON T KNUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 OLD MINNESOTA AVE, MANKATO CLINIC @ DANIELS HEALTH CENTER, SAINT PETER, MN 56082-1763
(507) 934-2325
Mailing address
PO BOX 8674, MAKATO CLINIC LTD 1230 E. MAIN STREET, MANKATO, MN 56002-8674
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
26414
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044003500
—
MN
01
—
1202175
U CARE
MN
01
—
1443257
AMERICAS PPO
MN
01
—
370005386
RR MEDICARE
—
01
—
410849339 56001 C058
CHAMPUS
—
01
—
53202KN
BC BS
MN
05
—
938134
—
IA
01
—
HP25600
HEALTH PARTNERS
MN
01
—
NA2951023843
PREFERRED ONE
MN
Enumeration date
01/09/2006
Last updated
07/10/2020
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