Individual
DR. ZACHARY BLAKE DIRKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
320 SUNRISE DR, SAINT PETER, MN 56082-1352
(507) 931-6436
(504) 934-9625
Mailing address
320 SUNRISE DR, SAINT PETER, MN 56082-1352
(507) 931-6436
(504) 934-9625
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3080
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0322460001
DMERC
MN
01
—
076N5DI
BCBS
MN
01
—
1051614
PREFERRED ONE
MN
01
—
1366640377
IOWA MEDICAID
MN
01
—
139494
UCARE
MN
01
—
2116066
MEDICA EYEWEAR/CARE
MN
01
—
44977TH
BLUE PLUS EYEWEAR/CARE
MN
01
—
HP82001
HEALTH PARTNERS
MN
Enumeration date
07/11/2007
Last updated
02/29/2008
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