Provider Demographics
NPI:1467431585
Name:ALTO, JEFFREY HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:HENRY
Last Name:ALTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-1752
Mailing Address - Country:US
Mailing Address - Phone:524-422-1919
Mailing Address - Fax:952-442-8055
Practice Address - Street 1:625 S 4TH ST STE A
Practice Address - Street 2:
Practice Address - City:LE SUEUR
Practice Address - State:MN
Practice Address - Zip Code:56058-2203
Practice Address - Country:US
Practice Address - Phone:507-593-5920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN39907207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110170017OtherRR MEDICARE
MN29B00ALOtherBCBS
MN273961500Medicaid
MN0408405OtherMEDICA
MNHP23870OtherHEALTH PARTNERS
MN1092848OtherAMERICAS PPO
MN120959OtherUCARE
MNNA2951023809OtherPREFERRED ONE
41084933956001C124OtherCHAMPUS
MN120959OtherUCARE
MN110005109Medicare ID - Type Unspecified
MNNA2951023809OtherPREFERRED ONE