Dr Gerard O'Halloran ENT & Facial Plastic Surgery PA

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

30984 Issued in MN

Legal business name

DR GERARD O'HALLORAN ENT & FACIAL PLASTIC SURGERY PA

Practice address

1645 Lyndale Ave N
Suite 3
Faribault, MN 55021-2934

Phone

(612) 590-0175

Fax

(651) 493-0968

NPI assigned

Nov 7, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gerard L O'Halloran, MD

Title

President

Phone

(612) 590-0175

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289088000000",
    "number": "1215238225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5133 SHERIDAN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102238",
            "telephone_number": "612-590-0175",
            "fax_number": "651-493-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 LYNDALE AVE N",
            "address_2": "SUITE 3",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550212934",
            "telephone_number": "612-590-0175",
            "fax_number": "651-493-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR GERARD O'HALLORAN ENT & FACIAL PLASTIC SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-07",
        "last_updated": "2010-11-07",
        "status": "A",
        "authorized_official_last_name": "O'HALLORAN",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-590-0175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "30984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040000375",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Discovery Public School of Faribault
• Julie A Donahue, NP
• Alexus Nicole Donkers
• Tasha Dornquast
• Emmanuel Douah, RPH
• Dr. Robert J. Erickson, P.a.
• Dr. Warren Johnson, DDS
• Kris W Drevlow, DO
• Elizabeth K Drewitz, PSYD, LP
• Jill Marie Drewitz

• Otolaryngology Physician in Faribault, MN
• Providers in Faribault, MN by specialty
• Otolaryngology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.