Kjome, Donald Wayne

Kjome, Donald Wayne is an individual health care provider with primary practice located at 967 Lake St S , Forest Lake MN 55025-2616. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kjome, Donald Wayne can be contacted via phone (651) 464-1113.

Contact Information

Primary practice address
967 Lake St S Forest Lake MN 55025-2616
Phone: (651) 464-1113
Fax: (651) 464-0853
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22028 Minnesota

Profile Details

NPI number 1588749642
LBN Legal business name Kjome, Donald Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2006
Last updated Mar 17th, 2018 - about 6 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 1588749642 NPPES
Minnesota MEDICAID 195588800

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