Individual
RANDALL THORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21260 CHIPPENDALE AVE W, FARMINGTON, MN 55024-1427
(651) 463-7181
(651) 241-0829
Mailing address
21260 CHIPPENDALE AVE W, FARMINGTON, MN 55024-1427
(651) 463-7181
(651) 241-0829
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
69892
MN
207Q00000X
Family Medicine Physician
RL15080
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RL15080
ND LICENSE
ND
Enumeration date
05/15/2018
Last updated
10/15/2021
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