| Founders Park Clinic, Pllc | |
|
211 Founders Park Dr Suite 3 Rapid City SD 57701-8098 | |
| (605) 791-5959 | |
| (605) 791-5960 |
| Full Name | Founders Park Clinic, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 211 Founders Park Dr, Rapid City, South Dakota |
| Authorized Official Name and Position | Martin S Spahn (PRESIDENT) |
| Authorized Official Contact | 6057915959 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Founders Park Clinic, Pllc 211 Founders Park Dr Suite 3 Rapid City SD 57701-8098 Ph: (605) 791-5959 | Founders Park Clinic, Pllc 211 Founders Park Dr Suite 3 Rapid City SD 57701-8098 Ph: (605) 791-5959 |
| NPI Number | 1386927465 |
|---|---|
| Provider Enumeration Date | 09/24/2011 |
| Last Update Date | 09/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386927465 | NPI | - | NPPES |
| 6702250 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | LLC ID# DL020085 (South Dakota) | Primary |
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