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NPI Code Detail

MEDICARE: SHARON KAY LORTON M.S., O.D.

MEDICARE: SHARON KAY LORTON M.S., O.D.
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
1152W00000XOptometrist2047MN

General Provider Information

NPI Number : 1669539060
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON KAY LORTON M.S., O.D.
Provider Business Mailing Address
First Line : 2702 FULTON CIR
Second Line :
City : CLEARWATER
State : MN
Zip : 55320-1304
Country : US
Telephone Number : 320-558-6872
Fax Number :
Provider Business Practice Location Address
First Line : 3950 VETERANS DR
Second Line : 3950 VETERANS DR.
City : SAINT CLOUD
State : MN
Zip : 56303-3410
Country : US
Telephone Number : 320-258-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 08/16/2007

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