Provider Demographics
NPI:1639160583
Name:PINKERTON, BRETT A (MD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:A
Last Name:PINKERTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CENTRACARE CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-5000
Mailing Address - Country:US
Mailing Address - Phone:320-654-3630
Mailing Address - Fax:320-654-3657
Practice Address - Street 1:1900 CENTRACARE CIR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-5000
Practice Address - Country:US
Practice Address - Phone:320-654-3630
Practice Address - Fax:320-654-3657
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40330207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1015082OtherPREFERRED ONE
216D4PIOtherBLUE CROSS BLUE SHIELD
768426OtherARAZ GROUP AMERICAS PPO
HP35805OtherHEALTH PARTNERS
0703706OtherMEDICA HEALTH PLANS
122273OtherUCARE
219216100OtherMEDICAL ASSISTANCE MA
219216100OtherMEDICAL ASSISTANCE MA
122273OtherUCARE
219216100OtherMEDICAL ASSISTANCE MA