Organization
DRS MOULTON & PARSONS MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH BUELL MOULTON MD (PARTNER)
(507) 375-3141
Entity
Organization
Contact information
Practice address
502 2ND AVE S, ST JAMES, MN 56081
(507) 375-3141
Mailing address
502 2ND AVE S, ST JAMES, MN 56081
(507) 375-3141
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0120470
MEDICA
MN
01
—
113049
U CARE
MN
01
—
42401MO
BLUE SHIELD
MN
Enumeration date
01/18/2007
Last updated
08/22/2020
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