MEDICARE: RONALD F HUEBSCH OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	1783	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265617641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD F HUEBSCH OD

Provider Business Mailing Address
First Line	:	523 1ST ST
Second Line	:
City	:	PRINCETON
State	:	MN
Zip	:	55371-1603
Country	:	US
Telephone Number	:	763-389-3150
Fax Number	:	763-389-0664

Provider Business Practice Location Address
First Line	:	523 1ST ST
Second Line	:
City	:	PRINCETON
State	:	MN
Zip	:	55371-1603
Country	:	US
Telephone Number	:	763-389-3150
Fax Number	:	763-389-0664

Authorized Official
Title or Position	:	OPTOMETRIST OWNER
Name	:	DR. RONALD F HUEBSCH
Credential	:	OD
Telephone Number	:	763-389-3150

Provider Enumeration Date	:	01/04/2008
Last Update Date	:	06/25/2008

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