Family Medicine Clinic Of Yankton Professional Llc | |
1000 West 4th Street Suite 15 Family Medicine Clinic Of Yankton Prof Llc Yankton SD 57078 | |
(605) 665-0555 | |
(605) 665-4498 |
Full Name | Family Medicine Clinic Of Yankton Professional Llc |
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Speciality | Family Medicine |
Location | 1000 West 4th Street, Yankton, South Dakota |
Authorized Official Name and Position | Kelly R Rafferty (SOLE MEMBER) |
Authorized Official Contact | 6056650555 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Medicine Clinic Of Yankton Professional Llc 1000 West 4th Street Suite 15 Family Medicine Clinic Of Yankton Prof Llc Yankton SD 57078 Ph: (605) 665-0555 | Family Medicine Clinic Of Yankton Professional Llc 1000 West 4th Street Suite 15 Family Medicine Clinic Of Yankton Prof Llc Yankton SD 57078 Ph: (605) 665-0555 |
NPI Number | 1811088727 |
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Provider Enumeration Date | 09/27/2006 |
Last Update Date | 04/05/2013 |
Medicare PECOS PAC ID | 3072425131 |
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Medicare Enrollment ID | O20031105000697 |
Identifier | Type | State | Issuer |
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1811088727 | NPI | - | NPPES |
5610162 | Medicaid | SD |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 4270 (South Dakota) | Primary |
Provider Name | Kelly Rae Rafferty |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609911098 PECOS PAC ID: 0941112015 Enrollment ID: I20031110000402 |
James D Kerr Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 613 Walnut St, Yankton, SD 57078 Phone: 605-660-9958 Fax: 605-689-3101 | |