Organization · NPI-2
Avera Mckennan
Family Medicine · Sioux Falls, SD
NPI number1457648149
StatusActive
Last updated in NPPESMay 16, 2012
Details
- NPI
- 1457648149
- Entity type
- Organization (NPI-2)
- Legal business name
- Avera Mckennan
- Organization subpart
- No
- Enumeration date
- Jul 1, 2011
- Last updated
- May 16, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Avera Medical Group Mcgreevy West Benson Road (Doing Business As)
Practice location
4011 W Benson RdSioux Falls, SD 57107-0104
Phone 605-322-1500 · Fax 605-322-1510
Mailing address
Po Box 86430Sioux Falls, SD 57118-6430
Phone 605-322-4900 · Fax 605-322-4910
Authorized official
Julie N Norton
Senior Vice President Of Finance
6053226375
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