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Individual

TODD GORDON BAUMGARTNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
313 1ST ST SE, LITTLE FALLS, MN 56345-3005
(320) 632-3673
(320) 632-3677
Mailing address
313 1ST ST SE, LITTLE FALLS, MN 56345-3005
(320) 632-3673
(320) 632-3677

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2114
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01006332
PREFERRED ONE
MN
05
058823700
MN
01
121964E979
UCARE
MN
01
22-14261
MEDICA
MN
01
410029610
RAILROAD MEDICARE
MN
01
4C930BA
BLUE CROSS BLUE SHIELD
FM
01
HP26999
HEALTH PARTNERS
MN
Enumeration date
07/27/2006
Last updated
09/16/2014
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