Organization
SOUTHERN CITIES CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ELLS PHARMD (AMBULATORY CARE EXECUTIVE DIRECTOR)
(651) 539-7200
Entity
Organization
Contact information
Practice address
400 4TH ST NW, FARIBAULT, MN 55021-5031
(507) 384-6830
Mailing address
3200 LABORE RD STE 104, VADNAIS HEIGHTS, MN 55110-5186
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
496053000
—
MN
Enumeration date
12/06/2006
Last updated
01/28/2026
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