Individual
TODD J GAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
23886 STATE HIGHWAY 22, MANKATO, MN 56001-7546
(507) 625-1424
Mailing address
23886 STATE HIGHWAY 22, MANKATO, MN 56001
(507) 625-1424
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35388
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0802344
MEDICA
MN
01
—
115539
UCARE
MN
01
—
180021519
RR MEDICARE
—
01
—
1M469GA
BCBS
MN
01
—
41084933956001C043
CHAMPUS
—
05
—
676207700
—
MN
05
—
937847
—
IA
01
—
970917
AMERICAS PPO
MN
01
—
HP25582
HEALTH PARTNERS
MN
01
—
NA2951011001
PREFERRED ONE
MN
Enumeration date
01/10/2006
Last updated
10/27/2022
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