Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 40471 | MN |
Y | 208600000X | Surgeon | 40471 | MN |
N | 208200000X | Surgeon | 4321 | SD |
N | 208600000X | Surgeon | 4321 | SD |
NPI | 1013008366 |
---|---|
Provider Name | Dr. Timothy W. Huisken |
First Address | Mankato, MN 56001-5066 |
Second Address | Mankato, MN 56001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 07/08/2020 |