Healthcare Provider Details

I. General information

NPI: 1225299449
Provider Name (Legal Business Name): ALEX ROBERT SCHOLL DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 11/10/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 1ST ST W
HASTINGS MN
55033-1147
US

IV. Provider business mailing address

1210 1ST ST W
HASTINGS MN
55033-1147
US

V. Phone/Fax

Practice location:
  • Phone: 651-438-1800
  • Fax: 651-438-1894
Mailing address:
  • Phone: 651-438-1800
  • Fax: 651-438-1894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number890
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number890
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number986-025
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number890
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: