Individual
LARRY BURTON OKERLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4300 MARKETPOINTE DR STE 100, BLOOMINGTON, MN 55435-5435
(952) 835-9880
(952) 857-1554
Mailing address
4300 MARKETPOINTE DR STE 100, BLOOMINGTON, MN 55435-5435
(952) 835-9880
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26600
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080075002
RAILROAD MEDICARE
GA
05
—
557203700
—
MN
01
—
5H099OK
BCBS
MN
01
—
N003453
CHAMPUS
MN
Enumeration date
06/22/2006
Last updated
11/06/2024
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