Organization
LITTLE CANADA MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES WILLIAM ALLAN M.D. (PRESIDENT)
(651) 481-1119
Entity
Organization
Contact information
Practice address
75 LITTLE CANADA RD W, LITTLE CANADA, MN 55117-1362
(651) 481-1119
(651) 481-1476
Mailing address
75 LITTLE CANADA RD W, LITTLE CANADA, MN 55117-1362
(651) 481-1119
(651) 481-1476
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
20780
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0123164
MEDICA
MN
01
—
20504LI
BLUE CROSS BLUE SHEILD
MN
05
—
263273000
—
MN
01
—
D80937
UPIN
MN
Enumeration date
07/15/2010
Last updated
07/15/2010
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