Organization
JRK MEDICALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN GORDON (SUPERVISOR)
(630) 216-9514
Entity
Organization
Contact information
Practice address
400 VILLAGE CENTER DR, NORTH OAKS, MN 55127-7848
(651) 765-8346
Mailing address
PO BOX 5865, ROCHESTER, MN 55903-5865
(702) 453-3799
(702) 453-5741
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
47952
MN
207RC0000X
Cardiovascular Disease Physician
Primary
47952
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47952
MN MEDICAL LICENSE
MN
Enumeration date
11/19/2015
Last updated
10/18/2023
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