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Contact Information

JOHN R LIDDICOAT, MD
7601 NORTHLAND DR N
MINNEAPOLIS, MN55428-4500
 Phone: 763-360-7961
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Thoracic Surgery (Cardiothoracic Vascular Surgery)

208G00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for JOHN R LIDDICOAT · (Male)

NPI Number 1750579694
Status Active
Credentials MD
Entity Individual
Enumeration date 10/04/2007
Last updated 10/04/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 209670
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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