Provider Demographics
NPI:1174565345
Name:ORTHOPAEDIC & FRACTURE CLINIC P A
Entity type:Organization
Organization Name:ORTHOPAEDIC & FRACTURE CLINIC P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-386-6734
Mailing Address - Street 1:1431 PREMIER DRIVE
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6076
Mailing Address - Country:US
Mailing Address - Phone:507-386-6600
Mailing Address - Fax:507-625-5971
Practice Address - Street 1:1431 PREMIER DRIVE
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6076
Practice Address - Country:US
Practice Address - Phone:507-386-6600
Practice Address - Fax:507-625-5971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN47332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN277640001Medicare ID - Type UnspecifiedDMEPOS, MANKATO
MNC06993Medicare ID - Type UnspecifiedMEDICARE SUPPLIES MANKATO
MN1174565345Medicare NSC