Organization · NPI-2

Avera Mckennan

Family Medicine · Sioux Falls, SD

NPI number1851468532

StatusActive

Last updated in NPPESOct 20, 2016

Details

NPI: 1851468532
Entity type: Organization (NPI-2)
Legal business name: Avera Mckennan
Organization subpart: No
Enumeration date: Nov 29, 2006
Last updated: Oct 20, 2016

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207Q00000X	Family Medicine	–	–	Yes
207R00000X	Internal Medicine	–	–

Other names

Avera Medical Group Family Health Center (Doing Business As)

Practice location

2100 S. Marion Rd.
Sioux Falls, SD 57106-3646

Phone 605-322-1010 · Fax 605-322-1011

Mailing address

Po Box 86430
Sioux Falls, SD 57118-6430

Phone 605-322-4900 · Fax 605-322-4910

Authorized official

Julie N Norton
Sr Vice President Of Financre
6053226375

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