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Individual

DR. JOHN THEOPHILE LINDQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD LP

Contact information

Practice address
521 BROADWAY AVENUE NORTH, FIVE COUNTY MENTAL HEALTH CENTER, BRAHAM, MN 55006
(320) 396-3333
(320) 396-3363
Mailing address
FIVE COUNTY MENTAL HEALTH CENTER, 521 BROADWAY AVENUE NORTH PO BOX 287, BRAHAM, MN 55006
(320) 396-3333
(320) 396-3363

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4385
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1023485
PREFERRED ONE
01
111284
OPTUM
01
148M4LI
BCBS
01
6140901
UBH
01
HP37277
HEALTHPARTNERS
01
P00026889
RAILROAD MEDICARE
Enumeration date
02/07/2007
Last updated
07/08/2007
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