Healthcare Provider Details

I. General information

NPI: 1326031287
Provider Name (Legal Business Name): DRS. AKRE & CLARK, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 04/08/2021
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 S BROADWAY ST
NEW ULM MN
56073-3751
US

IV. Provider business mailing address

PO BOX 727
NEW ULM MN
56073-0727
US

V. Phone/Fax

Practice location:
  • Phone: 507-354-8531
  • Fax: 507-359-1124
Mailing address:
  • Phone: 507-354-8531
  • Fax: 507-359-1124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: THOMAS E CLARK
Title or Position: PRESIDENT/OWNER
Credential: O.D.
Phone: 507-354-8531