Jacob Lewis Hemenway, PAC
Physician Assistant, Surgical in Rapid City, SD. Individual provider (NPI-1).
NPI number1982123725
StatusActive
Last updated in NPPESJul 16, 2024
Details
- NPI
- 1982123725
- Entity type
- Individual (NPI-1)
- Name
- Jacob Lewis Hemenway
- Credential
- PAC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 13, 2017
- Certification date
- Jul 16, 2024
- Last updated
- Jul 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | – | – | Yes |
Practice location
7220 Mount Rushmore RdRapid City, SD 57702-8754
Phone 605-341-1414 · Fax 605-341-7062
Mailing address
Po Box 6850Rapid City, SD 57709-6850
Phone 605-341-1414 · Fax 605-341-7062
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