MEDICARE: MR. THOMAS LYNN TAUSCHECK DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	327	MN

General Provider Information

NPI Number	:	1356346829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS LYNN TAUSCHECK DPM

Provider Business Mailing Address
First Line	:	4001 STINSON BLVD
Second Line	:	STE 232
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55421-3424
Country	:	US
Telephone Number	:	612-788-7274
Fax Number	:	612-788-3408

Provider Business Practice Location Address
First Line	:	4001 STINSON BLVD
Second Line	:	STE 232
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55421-3424
Country	:	US
Telephone Number	:	612-788-7274
Fax Number	:	612-788-3408

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	07/08/2007

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