Basic Information
| Provider Information | |||||||||
| NPI: | 1649285495 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STRAUGHAN | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2353 RICE ST | ||||||||
| Address2: | #209 | ||||||||
| City: | ROSEVILLE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551133739 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126166040 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1805 HENNEPIN AVE N | ||||||||
| Address2: | |||||||||
| City: | GLENCOE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553361416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3208643121 | ||||||||
| FaxNumber: | 3208647887 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 38757 | MN | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.