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NPI Code Detail

MEDICARE: JANNING ENT CENTER, LLC

MEDICARE: JANNING ENT CENTER, LLC
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
1207Y00000XOtolaryngology Physician40016MN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00251507OTHERMNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2313S2JAOTHERMNBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1952332629
Entity Type Code : Organization
Provider Name (Legal Business Name) : JANNING ENT CENTER, LLC
Provider Business Mailing Address
First Line : 1801 19TH AVE SW
Second Line :
City : WILLMAR
State : MN
Zip : 56201-4946
Country : US
Telephone Number : 320-231-3277
Fax Number : 320-214-5758
Provider Business Practice Location Address
First Line : 1801 19TH AVE SW
Second Line :
City : WILLMAR
State : MN
Zip : 56201-4946
Country : US
Telephone Number : 320-231-3277
Fax Number : 320-214-5758
Authorized Official
Title or Position : OWNER
Name : DR. MARTIN HEINZ JANNING
Credential : M.D.
Telephone Number : 320-231-3277
Provider Enumeration Date : 07/05/2006
Last Update Date : 10/10/2024

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Directions to “JANNING ENT CENTER, LLC ” Practice Location

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