Individual
ANITA T JONASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27043
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105972
MEDICA #
MN
01
—
0105973
MEDICA #
MN
01
—
160883
UCARE #
MN
05
—
17130
—
MN
01
—
6105910
MNBS #
MN
01
—
6466
NDBS #
MN
01
—
911075
AMERICA'S PPO/ARAZ #
MN
05
—
937282200
—
MN
01
—
DA9031015651
PREFERRED ONE #
MN
01
—
HP19547
HEALTHPARTNERS #
MN
01
—
MN100022
LHS/BANNERHEALTH #
MN
Enumeration date
05/27/2006
Last updated
11/22/2011
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