Individual
KELLIE L MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
46790
MN
208C00000X
Colon & Rectal Surgery Physician
Primary
46790
MN
Other
Enumeration date
01/23/2006
Last updated
08/18/2020
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