Provider Demographics
NPI:1295841625
Name:DOWNTOWN ORTHOPEDICS, P.A.
Entity Type:Organization
Organization Name:DOWNTOWN ORTHOPEDICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:WENGLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-338-7697
Mailing Address - Street 1:825 S 8TH ST
Mailing Address - Street 2:SUITE 902
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-1208
Mailing Address - Country:US
Mailing Address - Phone:612-338-7697
Mailing Address - Fax:612-338-3954
Practice Address - Street 1:825 S 8TH ST
Practice Address - Street 2:SUITE 902
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-1208
Practice Address - Country:US
Practice Address - Phone:612-338-7697
Practice Address - Fax:612-338-3954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN373810800Medicaid
MN373810800Medicaid
MN373810800Medicaid