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201 S Lloyd St Suite W270 Aberdeen SD 57401-4552 | |
| (605) 225-4070 | |
| (605) 725-2416 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 201 S Lloyd St, Aberdeen, South Dakota |
| Authorized Official Name and Position | Ron L Jacobson (PRESIDENT & CEO) |
| Authorized Official Contact | 6056225125 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1460 Aberdeen SD 57402-1460 Ph: (605) 225-4070 | 201 S Lloyd St Suite W270 Aberdeen SD 57401-4552 Ph: (605) 225-4070 |
| NPI Number | 1477750289 |
|---|---|
| Provider Enumeration Date | 06/27/2007 |
| Last Update Date | 06/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477750289 | NPI | - | NPPES |
| 9251433 | Other | SD | DAKOTACARE |
| 14389 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 10525 (South Dakota) | Primary |
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