Individual
DR. THOMAS RICHARD ROLLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
705 PLEASANT AVE S, PARK RAPIDS, MN 56470-1440
(218) 732-2800
(218) 732-2874
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(218) 732-2800
(218) 732-2874
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25137
MN
207Q00000X
Family Medicine Physician
38114
IA
207Q00000X
Family Medicine Physician
50543-02
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508828948
—
MN
05
—
472765700
—
MN
Enumeration date
04/03/2006
Last updated
02/04/2013
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