Stakston, Malin Craig

Stakston, Malin Craig is an individual health care provider with primary practice located at 12548 Parkwood Dr , Burnsville MN 55337. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Stakston, Malin Craig can be contacted via phone (952) 895-8505.

Contact Information

Primary practice address
12548 Parkwood Dr Burnsville MN 55337
Phone: (952) 895-8505
Fax: (952) 890-7787
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1535 Minnesota

Profile Details

NPI number 1861568727
LBN Legal business name Stakston, Malin Craig
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 24th, 2006
Last updated Jul 8th, 2007 - about 18 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 1861568727 NPPES
Minnesota Other 33335 BCBS MPIN#
Minnesota Other 989810743001 BCBS MPIN#
Minnesota Other 16742ST BCBS MPIN#
Minnesota Other 33335 BCBS MPIN#

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