| |
205 Orchard Dr Sisseton SD 57262-2398 | |
(605) 698-7681 | |
(605) 698-3493 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 205 Orchard Dr, Sisseton, South Dakota |
Authorized Official Name and Position | Craig Kantos (CEO) |
Authorized Official Contact | 6056984601 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
205 Orchard Dr Sisseton SD 57262-2398 Ph: (605) 698-7681 | 205 Orchard Dr Sisseton SD 57262-2398 Ph: (605) 698-7681 |
NPI Number | 1659410009 |
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Provider Enumeration Date | 02/05/2007 |
Last Update Date | 08/08/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659410009 | NPI | - | NPPES |
05160 | Medicaid | ND | |
30701162 | Other | PRIMEWEST | |
56G45CO | Other | BLUE CROSS | |
0030064 | Other | BLUE CROSS | |
60184CO | Other | BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 60020 (South Dakota) | Secondary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Us Dept Of Health & Human Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Lake Traverse Dr, Sisseton, SD 57262 Phone: 605-698-7606 | |
Sisseton Wahpeton Health Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Lake Traverse Dr, Sisseton, SD 57262 Phone: 605-698-7606 | |