Avera Medical Group Fairfax | |
421 Main St Fairfax SD 57335-0354 | |
(605) 654-2366 | |
Not Available |
Full Name | Avera Medical Group Fairfax |
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Speciality | Clinic/center |
Location | 421 Main St, Fairfax, South Dakota |
Authorized Official Name and Position | Julie N Norton (VICE PRESIDENT OF FINANCE) |
Authorized Official Contact | 6053226375 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Avera Medical Group Fairfax Po Box 354 421 Main Fairfax SD 57335-0354 Ph: (605) 654-2366 | Avera Medical Group Fairfax 421 Main St Fairfax SD 57335-0354 Ph: (605) 654-2366 |
NPI Number | 1215967203 |
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Provider Enumeration Date | 07/04/2006 |
Last Update Date | 03/21/2011 |
Identifier | Type | State | Issuer |
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1215967203 | NPI | - | NPPES |
0000028 | Other | SD | WELLMARK BC/BS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |