Provider Demographics
NPI:1356346829
Name:TAUSCHECK, THOMAS LYNN (DPM)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:LYNN
Last Name:TAUSCHECK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4001 STINSON BLVD
Mailing Address - Street 2:STE 232
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-3424
Mailing Address - Country:US
Mailing Address - Phone:612-788-7274
Mailing Address - Fax:612-788-3408
Practice Address - Street 1:4001 STINSON BLVD
Practice Address - Street 2:STE 232
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55421-3424
Practice Address - Country:US
Practice Address - Phone:612-788-7274
Practice Address - Fax:612-788-3408
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN327213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNT39898Medicare UPIN
MN48000316Medicare ID - Type Unspecified