Individual
MICHAEL THOMAS ECKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
404 W FOUNTAIN ST, ALBERT LEA, MN 56007-2437
(507) 373-2384
Mailing address
72099 WINEGLASS RD, ALBERT LEA, MN 56007-5579
(507) 377-2776
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
43291
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620008700
—
MN
Enumeration date
01/14/2006
Last updated
09/28/2020
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