Healthcare Provider Details

I. General information

NPI: 1457494551
Provider Name (Legal Business Name): MINNESOTA ONCOLOGY HEMATOLOGY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 SMITH AVE N SUITE 480
SAINT PAUL MN
55102-2393
US

IV. Provider business mailing address

310 SMITH AVE N SUITE 480
SAINT PAUL MN
55102-2393
US

V. Phone/Fax

Practice location:
  • Phone: 651-602-5200
  • Fax: 651-602-5390
Mailing address:
  • Phone: 651-602-5200
  • Fax: 651-602-5390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number1076
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number1076
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number1076
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number1076
License Number StateMN

VIII. Authorized Official

Name: THOMAS P FLYNN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 612-863-8585