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Organization

HEARTLAND ORTHOPEDIC SPECIALISTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL S DOYLE (ADMINISTRATOR)
(320) 762-1144
Entity
Organization

Contact information

Practice address
111 17TH AVE E, SUITE 101, ALEXANDRIA, MN 56308-3703
(320) 762-1144
(320) 762-1935
Mailing address
111 17TH AVE E, SUITE 101, ALEXANDRIA, MN 56308-3734
(320) 762-1144
(320) 762-1935

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
213ES0103X
Foot & Ankle Surgery Podiatrist
225100000X
Physical Therapist
2255A2300X
Athletic Trainer
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
104667
UCARE
01
30701054
PRIMEWEST
01
564
LICENSE
MN
01
61006AL
BC/BS
05
888210000
MN
01
CP4310
TRAVELERS MEDICARE
MN
Enumeration date
09/22/2006
Last updated
01/27/2011
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