MEDICARE: RONALD HUEBSCH OD

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	152W00000X	Optometrist	1783	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2115731	OTHER	MN	MEDICA MATERIALS
2	2202702	OTHER	MN	MEDICA HEALTH CARE PLAN
3	5C026HU	OTHER		BC/BS (MATERIALS)
4	960380688001	OTHER		PREFERRED ONE
5	4676	OTHER		HEALTH PARTNERS
6	52393HU	OTHER		BLUE CROSS/BLUE SHIELD
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	115240	OTHER	MN	U-CARE

General Provider Information

NPI Number	:	1689665705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD HUEBSCH OD

Provider Business Mailing Address
First Line	:	523 1ST ST
Second Line	:
City	:	PRINCETON
State	:	MN
Zip	:	55371-1603
Country	:	US
Telephone Number	:	763-389-3150
Fax Number	:	763-389-0664

Provider Business Practice Location Address
First Line	:	523 1ST ST
Second Line	:
City	:	PRINCETON
State	:	MN
Zip	:	55371-1603
Country	:	US
Telephone Number	:	763-389-3150
Fax Number	:	763-389-0664

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	05/16/2012

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Directions to “ RONALD HUEBSCH OD” Practice Location

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