Individual
JAMES J O'HEARN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2019 S 6TH ST, BRAINERD, MN 56401-4528
(218) 822-4242
(218) 822-3758
Mailing address
2019 S 6TH ST, BRAINERD, MN 56401-4528
(218) 822-4242
(218) 822-3758
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
42015
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0120300
PREFERRED ONE
MN
05
—
1601238
—
MN
01
—
21G130H
BCBS
MN
Enumeration date
07/05/2006
Last updated
07/08/2007
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