| Creekside Family Practice | |
|
2620 Jackson Blvd Suite C Rapid City SD 57702-3478 | |
| (605) 341-1208 | |
| (605) 341-3552 |
| Full Name | Creekside Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 2620 Jackson Blvd, Rapid City, South Dakota |
| Authorized Official Name and Position | Craig K Hansen (OWNER) |
| Authorized Official Contact | 6053481208 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Family Practice 2620 Jackson Blvd Suite C Rapid City SD 57702-3478 Ph: (605) 341-1208 | Creekside Family Practice 2620 Jackson Blvd Suite C Rapid City SD 57702-3478 Ph: (605) 341-1208 |
| NPI Number | 1447449079 |
|---|---|
| Provider Enumeration Date | 10/19/2007 |
| Last Update Date | 01/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447449079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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