Provider Demographics
NPI:1285879544
Name:EDGERTON, DAVID EARL JR (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:EARL
Last Name:EDGERTON
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1108 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-3440
Mailing Address - Country:US
Mailing Address - Phone:320-631-2226
Mailing Address - Fax:320-632-3728
Practice Address - Street 1:1108 1ST ST SE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3440
Practice Address - Country:US
Practice Address - Phone:320-631-2200
Practice Address - Fax:320-632-3728
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN106240207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery