Provider Demographics
NPI:1184871295
Name:STRATTE, JON (MD)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:STRATTE
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 1:114 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-4238
Mailing Address - Country:US
Mailing Address - Phone:651-439-4210
Mailing Address - Fax:
Practice Address - Street 1:114 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-4238
Practice Address - Country:US
Practice Address - Phone:651-439-4210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN16632207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine