Provider Demographics
NPI:1699770941
Name:PAGE, LAWRENCE V (DO)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:V
Last Name:PAGE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-9000
Mailing Address - Fax:612-262-9035
Practice Address - Street 1:1217 8TH ST N
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-1552
Practice Address - Country:US
Practice Address - Phone:507-217-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN69267207X00000X
KS0524850207X00000X
MO102737207X00000X
OK4865207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
250766OtherRAILROAD MEDICARE
220376OtherBCBS
250766OtherHEALTHLINK
OK100053140AMedicaid
MO246676928Medicaid
530114178Medicare PIN
220376OtherBCBS
OKOKA101025Medicare PIN
250766OtherHEALTHLINK