Organization · NPI-2

Avera Mckennan

Family Medicine · Sioux Falls, SD

NPI number1144635863
StatusActive
Last updated in NPPESJun 23, 2014

Details

NPI
1144635863
Entity type
Organization (NPI-2)
Legal business name
Avera Mckennan
Organization subpart
No
Enumeration date
Jun 23, 2014
Last updated
Jun 23, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Other names

  • Avera Medical Group 69th And Cliff (Doing Business As)

Practice location

6215 South Cliff Avenue
Sioux Falls, SD 57108-8589

Phone 605-322-3300 · Fax 605-322-3301

Mailing address

Po Box 86430
Sioux Falls, SD 57118-6430

Phone 605-322-4901 · Fax 605-322-4910

Authorized official

Julie Norton
Cfo
6053226375

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