| |
6100 S Louise Ave Ste 1120 Sioux Falls SD 57108-6021 | |
(605) 504-1700 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 6100 S Louise Ave Ste 1120, Sioux Falls, South Dakota |
Authorized Official Name and Position | David Flicek (CEO/PRESIDENT) |
Authorized Official Contact | 6053228000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 86370 Sioux Falls SD 57118-6370 Ph: (605) 322-7510 | 6100 S Louise Ave Ste 1120 Sioux Falls SD 57108-6021 Ph: (605) 504-1700 |
NPI Number | 1770558405 |
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Provider Enumeration Date | 02/17/2006 |
Last Update Date | 11/01/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770558405 | NPI | - | NPPES |
92411422901 | Other | MN | PRIMEWEST |
068417100 | Medicaid | MN | |
30B74GU | Other | MN | BLUE PLUS |
0532341 | Medicaid | IA | |
59767 | Other | SD | HEALTHPARTNERS |
30B74GU | Other | MN | BLUE CROSS |
370624200 | Other | SD | DEPT OF LABOR |
0006020 | Other | SD | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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