L.M. Affolter O.D.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

1370 Issued in MN

Legal business name

L.M. AFFOLTER O.D.

Practice address

121 N 3Rd St
Marshall, MN 56258-1324

Phone

(507) 532-5143

Fax

(507) 532-5143

NPI assigned

Mar 17, 2008

Last updated

Mar 17, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Leroy M Affolter, O.DO

Title

Owner

Phone

(507) 532-5143

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1588835649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N 3RD ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562581324",
            "telephone_number": "507-532-5143",
            "fax_number": "507-532-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N 3RD ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562581324",
            "telephone_number": "507-532-5143",
            "fax_number": "507-532-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L.M. AFFOLTER O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "AFFOLTER",
        "authorized_official_first_name": "LEROY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-532-5143",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.DO"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MN",
            "license": "1370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "46009AF",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5C002AF",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "11257",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2282361",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED",
            "identifier": "930531027150",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dylan Joseph Kratochvil, CNP
• William N Kremer Jr., MD
• Cody Allen Kruize, DC
• Taylor Ann Kruize, DC
• Catherine Kuehl, RN, CHW
• Ashley Ann Lackey
• Regina M Landrus, P.T.
• Amber Landsman, AU.D.
• Jessica Landsman, AUD
• Carol Lynn Lang, D.O.

• Eyewear Supplier in Marshall, MN
• Providers in Marshall, MN by specialty
• Eyewear Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.