Healthcare Provider Details

I. General information

NPI: 1437265956
Provider Name (Legal Business Name): RICHARD A LOCHNER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 11/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 S MINNESOTA ST
CROOKSTON MN
56716-1601
US

IV. Provider business mailing address

323 S MINNESOTA ST
CROOKSTON MN
56716-1601
US

V. Phone/Fax

Practice location:
  • Phone: 218-281-9553
  • Fax: 218-281-9393
Mailing address:
  • Phone: 218-281-9553
  • Fax: 218-281-9393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number324
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: