Provider Demographics
NPI:1609841626
Name:SPRINGER, JOHN ADOLPH (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ADOLPH
Last Name:SPRINGER
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 1:1431 PREMIER DR
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6076
Mailing Address - Country:US
Mailing Address - Phone:507-386-6600
Mailing Address - Fax:507-625-5971
Practice Address - Street 1:1431 PREMIER DR
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6076
Practice Address - Country:US
Practice Address - Phone:507-386-6600
Practice Address - Fax:507-625-5971
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN34278207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN120080C572OtherUCARE MN
MN983181004377OtherPREFERRED ONE
MN410940705H007OtherTRICARE/WPS
MN0901563OtherMEDICA, MANKATO
MN714008800Medicaid
MN0D615SPOtherBCBS OF MN
MN0900815OtherMEDICA, ST. PETER
MNHP18800OtherHEALTH PARTNERS
MN0922854OtherMEDICA, LESUEUR
MN714008800Medicaid
MNE89425Medicare UPIN
MN200019436Medicare ID - Type UnspecifiedPALMETTO GBA, RR MC