Dr Dale E Vizcarra, MD | |
100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | |
(605) 224-5901 | |
(605) 945-5096 |
Full Name | Dr Dale E Vizcarra |
---|---|
Gender | Female |
Speciality | Family Medicine |
Location | 100 Mac Lane, Pierre, South Dakota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992768469 | NPI | - | NPPES |
5609172 | Medicaid | SD | |
5609170 | Medicaid | SD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 3600 (South Dakota) | Secondary |
207Q00000X | Family Medicine | SD3600 (South Dakota) | Primary |
Entity Name | Avera Mckennan |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003389206 PECOS PAC ID: 0345157103 Enrollment ID: O20031110000117 |
Mailing Address | Practice Location Address |
---|---|
Dr Dale E Vizcarra, MD 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 Ph: (605) 224-5901 | Dr Dale E Vizcarra, MD 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 Ph: (605) 224-5901 |
Caitlin Jensen, Family Medicine Medicare: Medicare Enrolled Practice Location: 3100 E Sd Highway 34, Pierre, SD 57501 Phone: 605-773-7475 | |
Mr. Robert Allen Johnson, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 521 E Sioux Ave, Pierre, SD 57501 Phone: 605-945-5560 Fax: 605-224-0369 | |
Mr. Noel Dennis Chicoine, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 521 E Sioux Ave, Pierre, SD 57501 Phone: 605-945-5560 Fax: 605-224-0369 | |
Victor Craig Strasburg, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 100 Mac Ln, Pierre, SD 57501 Phone: 605-224-5901 | |
Dr. Teresa Jo Bormann, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 521 E Sioux Ave, Pierre, SD 57501 Phone: 605-945-5560 Fax: 605-224-0369 | |
Nielsen H. Burns, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 801 E Sioux Ave, Pierre, SD 57501 Phone: 605-224-3177 | |
Dr. Jenna Wickersham, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 521 E Sioux Ave, Pierre, SD 57501 Phone: 605-945-5560 |