Individual
TERESA F THEOBALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3308 W ARROWHEAD RD, DULUTH, MN 55811-4000
(218) 727-6400
(218) 464-4277
Mailing address
3308 W ARROWHEAD RD, DULUTH, MN 55811-4000
(218) 727-6400
(218) 464-4277
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2532
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114513
UCARE
MN
01
—
2203073
MEDICA
MN
01
—
2207595
MEDICA
MN
01
—
410036000
RAILROAD MEDICARE
MN
01
—
6C247TH
BCBS & ATRIUM
FM
01
—
6C247TH
FIRST PLAN MINNESOTA
MN
05
—
850527600
—
MN
01
—
897821009672
PREFERRED ONE
MN
01
—
A62871009672
PREFERRED ONE
MN
Enumeration date
02/23/2006
Last updated
11/24/2015
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