Erickson, Keith J

Erickson, Keith J is an individual health care provider with primary practice located at 13100 Wayzata Blvd Ste 200 , Minnetonka MN 55305-1810. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Erickson, Keith J can be contacted via phone (952) 206-2040.

Contact Information

Primary practice address
13100 Wayzata Blvd Ste 200 Minnetonka MN 55305-1810
Phone: (952) 206-2040
Fax: (952) 206-2041
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 36144 Minnesota
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 6210 North Dakota

Profile Details

NPI number 1619931185
LBN Legal business name Erickson, Keith J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2006
Last updated May 31st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619931185 NPPES
Minnesota Other 4T606ER BLUE CROSS BLUE SHIELD
Minnesota MEDICAID 103765000 BLUE CROSS BLUE SHIELD
Minnesota Other 12327 BLUE CROSS BLUE SHIELD
Minnesota MEDICAID 17911 BLUE CROSS BLUE SHIELD

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