Provider Demographics
NPI:1336316108
Name:BIRKHOLZ, EMILY SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:SUSAN
Last Name:BIRKHOLZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-4899
Mailing Address - Country:US
Mailing Address - Phone:507-345-6151
Mailing Address - Fax:507-625-1096
Practice Address - Street 1:1630 ADAMS ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4899
Practice Address - Country:US
Practice Address - Phone:507-345-6151
Practice Address - Fax:507-625-1096
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-8279207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology