Ted L Trueblood (NPI# 1871561886, PAC ID# 0941304471) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1871561886 |
| PAC ID by PECOS | 0941304471 |
| Professional Enrollment ID | I20070322000463 |
| Full Name | Ted L Trueblood |
| Organization Legal Name | ST JOSEPHS MEDICAL CENTER |
| Address |
35205 County Rd Suite 3 Crosslake MN 56442-4057 |
| Phone Number | 2186921010 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 1998 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 8224948443 |
| Number of Group Practice Members | 189 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 240075 | ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 35205 County Rd, Suite 3, Crosslake, MN 56442-4057 | 2186921010 | ST JOSEPHS MEDICAL CENTER |
| Organization Legal Name | ST JOSEPHS MEDICAL CENTER |
| Physicians | 132 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karli G Dullum | Nurse Practitioner | St Josephs Medical Center | 2024 S 6th St, Brainerd, MN 56401-4529 |
| Amy Borash | Physician Assistant | St Josephs Medical Center | 138 Main St S, Pierz, MN 56364-4400 |
| Stacy L Brazier | Anesthesiology | St Josephs Medical Center | 523 N 3rd St, Brainerd, MN 56401-3054 |
| Megan E.m. Gladen | Family Medicine | St Josephs Medical Center | 415 Barclay Ave, Pine River, MN 56474-5139 |
| Amy E Lelwica | Orthopedic Surgery | St Josephs Medical Center | 2014 S 6th St, Brainerd, MN 56401-4529 |
| Kelli B Leland | Family Medicine | St Josephs Medical Center | 221 Main St N, Pierz, MN 56364-1570 |
| Heidi L Malling | Hospitalist | St Josephs Medical Center | 523 N 3rd St, Brainerd, MN 56401-3054 |
| Mark W Haecker | Anesthesiology | St Josephs Medical Center | 523 N 3rd St, Brainerd, MN 56401-3054 |
| Deanne R Ehlert | Nurse Practitioner | St Josephs Medical Center | 523 N 3rd St, Brainerd, MN 56401-3054 |
| Mark Christopher Patnode | Emergency Medicine | St Josephs Medical Center | 523 N 3rd St, Brainerd, MN 56401-3054 |
| Street Address |
35205 COUNTY RD SUITE 3 |
| City | CROSSLAKE |
| State | MN |
| Zip | 56442-4057 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sara Marie Lokstad | Family Medicine | St Josephs Medical Center | 35205 County Rd, Suite 3, Crosslake, MN 56442-4057 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Derrek N Johnson | Chiropractic | 35272 County Rd, Suite 3, Crosslake, MN 56442-2804 | |
| Todd M Wiedell | Optometry | 13833 Riverwood Ln, Crosslake, MN 56442-2823 | |
| Krista Marie Johnson | Occupational Therapy | Wellnessone of Nisswa | 13833 Riverwood Ln, Suite 1, Crosslake, MN 56442-2823 |
| Anicia G Peterson | Chiropractic | 13743 E Shore Rd, Crosslake, MN 56442-4033 |
| City | CROSSLAKE |
| Zip Code | 56442 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | CROSSLAKE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Ted L Trueblood.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.