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General NPI Number Information
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NPI Number | 1700693512
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Entity Type | Organization
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Legal Business Name | ST. LUKE'S HOSPITAL OF DULUTH
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 50 OUTER DR
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City | SILVER BAY
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State | MN
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Zip | 55614-1102
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Country | US
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Telephone | 218-226-4431
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Fax |
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Provider Business Mailing Address
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Address Line | 50 OUTER DR
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City | SILVER BAY
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State | MN
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Zip | 55614-1102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SVP & CFO
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Name | JERRY YANG
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Credential |
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Telephone | 715-847-2526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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