| Mobridge Medical Clinic | |
|
1309 10th Ave West Mobridge SD 57601-0520 | |
| (605) 845-3692 | |
| (605) 845-8239 |
| Full Name | Mobridge Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1309 10th Ave West, Mobridge, South Dakota |
| Authorized Official Name and Position | Renae Tisdall (CFO) |
| Authorized Official Contact | 6058458164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobridge Medical Clinic Po Box 520 Mobridge SD 57601-0520 Ph: (605) 845-3692 | Mobridge Medical Clinic 1309 10th Ave West Mobridge SD 57601-0520 Ph: (605) 845-3692 |
| NPI Number | 1275502577 |
|---|---|
| Provider Enumeration Date | 03/17/2006 |
| Last Update Date | 01/20/2017 |
| Medicare PECOS PAC ID | 6507776135 |
|---|---|
| Medicare Enrollment ID | O20120216000292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275502577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | 438500 (South Dakota) | Primary |
Mobridge Family Practice Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 10th Ave W, Mobridge, SD 57601 Phone: 605-845-7292 Fax: 605-845-7812 | |
Mobridge Regional Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1401 10th Ave West, Mobridge, SD 57601 Phone: 605-845-3692 Fax: 605-845-8252 | |
Shadow Anesthesia Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 10th Ave W, Mobridge, SD 57601 Phone: 605-845-8271 Fax: 605-845-3502 |