Healthcare Provider Details

I. General information

NPI: 1871571174
Provider Name (Legal Business Name): ROBERT DOANE WASSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 HIGHWAY 71 NE
WILLMAR MN
56201-9504
US

IV. Provider business mailing address

1550 HIGHWAY 71 NE
WILLMAR MN
56201-9504
US

V. Phone/Fax

Practice location:
  • Phone: 320-231-5100
  • Fax: 320-231-5329
Mailing address:
  • Phone: 320-231-5100
  • Fax: 320-231-5329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number16311
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number16311
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: