Healthcare Provider Details

I. General information

NPI: 1467913889
Provider Name (Legal Business Name): LAURENCE GEORGE DUCKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 FRANCE AVE S
EDINA MN
55435-4787
US

IV. Provider business mailing address

7450 FRANCE AVE S STE 100
EDINA MN
55435-4799
US

V. Phone/Fax

Practice location:
  • Phone: 612-999-2020
  • Fax:
Mailing address:
  • Phone: 612-999-2020
  • Fax: 763-421-0730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number82360
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number82360
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: