Provider Demographics
NPI:1972526564
Name:AMON, ANTHONY G (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:G
Last Name:AMON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:502 2ND ST SW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-3365
Mailing Address - Country:US
Mailing Address - Phone:320-235-7232
Mailing Address - Fax:320-231-8609
Practice Address - Street 1:502 2ND ST SW
Practice Address - Street 2:SUITE 1
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3365
Practice Address - Country:US
Practice Address - Phone:320-235-7232
Practice Address - Fax:320-231-8609
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2022-06-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN37281207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP21637OtherHEALTH PARTNERS
MNMR1081007926OtherPREFERRED ONE
MN325101845OtherPRIMEWEST
MN6T222AMOtherBLUE CROSS BLUE SHIELD
MN114457OtherUCARE
MN772554OtherARAZ
MN01-01065OtherMEDICA
MN080061048OtherRR MEDICARE
MN972023500Medicaid
MN01-01065OtherMEDICA
MNMR1081007926OtherPREFERRED ONE