Individual
DR. ANDREW MATTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
17690 KENWOOD TRL, LAKEVILLE, MN 55044-9764
(952) 898-9588
(952) 898-2030
Mailing address
18160 LANSFORD PATH, LAKEVILLE, MN 55044-4956
(952) 212-0131
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
LD 2823000
MN
152WC0802X
Corneal and Contact Management Optometrist
LD 2823000
MN
152WP0200X
Pediatric Optometrist
LD 2823000
MN
152WX0102X
Occupational Vision Optometrist
LD 2823000
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176625200
—
MN
01
—
202779692
AETNA
MN
01
—
22-03175
UNITED HEALTH CARE
MN
01
—
500R7MA
BLUE CROSS BLUE SHIELD MN
MN
01
—
79G34LA
BLUE PLUS
MN
01
—
A61971031584
PREFERRED ONE
MN
01
—
HP36326
HEALTH PARTNERS
MN
Enumeration date
11/08/2006
Last updated
06/02/2011
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