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1600 W 22nd St Sioux Falls SD 57105-1521 | |
| (605) 312-1000 | |
| (605) 312-1001 |
| Full Name | |
|---|---|
| Speciality | Pediatrics |
| Location | 1600 W 22nd St, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Tony Lee Morrison (VICE PRESIDENT, REVENUE CYCLE) |
| Authorized Official Contact | 6053288380 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 5074 Sioux Falls SD 57117-5074 Ph: (605) 328-6585 | 1600 W 22nd St Sioux Falls SD 57105-1521 Ph: (605) 312-1000 |
| NPI Number | 1881610889 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 11/27/2023 |
| Certification Date | 07/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881610889 | NPI | - | NPPES |
| 916413800 | Medicaid | MN | |
| 0573469 | Medicaid | IA |
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