Provider Demographics
NPI:1437290186
Name:DR. ROBERT J. ERICKSON, P.A.
Entity Type:Organization
Organization Name:DR. ROBERT J. ERICKSON, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MEEHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-334-5627
Mailing Address - Street 1:200 8TH AVE NW
Mailing Address - Street 2:SUITE 5
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-5068
Mailing Address - Country:US
Mailing Address - Phone:507-334-9400
Mailing Address - Fax:507-331-2210
Practice Address - Street 1:200 8TH AVE NW
Practice Address - Street 2:SUITE 5
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-5068
Practice Address - Country:US
Practice Address - Phone:507-334-9400
Practice Address - Fax:507-331-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2235111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC06739Medicare PIN