Individual
DR. LANCE KANSAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 CURVE CREST BLVD W, STILLWATER, MN 55082-6040
(651) 439-1234
(651) 275-3325
Mailing address
927 CHURCHILL ST W, MEDICAL STAFF SERVICES, STILLWATER, MN 55082-6605
(651) 430-8537
(651) 430-4646
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47690
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0596163
—
IA
05
—
34680500
—
WI
05
—
842111100
—
MN
01
—
P00254933
RR MEDICARE
MN
Enumeration date
10/12/2006
Last updated
10/02/2007
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