Organization
LEXINGTON EYE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK WEDUL MD (PRESIDENT)
(651) 646-7419
Entity
Organization
Contact information
Practice address
1570 CONCORDIA AVE, SUITE 202, ST PAUL, MN 55104-5345
(651) 646-7419
(651) 637-2778
Mailing address
1570 CONCORDIA AVE, SUITE 202, ST PAUL, MN 55104-5345
(651) 646-7419
(651) 637-2778
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
29010
MN
207W00000X
Ophthalmology Physician
E15851
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219863100
—
MN
05
—
664275600
—
MN
Enumeration date
12/21/2006
Last updated
10/24/2016
Update your record
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