Provider Demographics
NPI:1942530464
Name:HITT, JOHN ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALAN
Last Name:HITT
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 1:5790 MARSH POINTE DR
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-7100
Mailing Address - Country:US
Mailing Address - Phone:952-513-8128
Mailing Address - Fax:
Practice Address - Street 1:4729 COUNTY ROAD 101
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-2634
Practice Address - Country:US
Practice Address - Phone:952-974-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN30456207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNE56910Medicare UPIN