| |
109 Pugh Street Martin SD 57551-0370 | |
(605) 685-1450 | |
(605) 685-1453 |
Full Name | |
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Speciality | Family Medicine |
Location | 109 Pugh Street, Martin, South Dakota |
Authorized Official Name and Position | Diane M Weber (OWNER) |
Authorized Official Contact | 6056851450 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 370 Martin SD 57551-0370 Ph: (605) 685-1450 | 109 Pugh Street Martin SD 57551-0370 Ph: (605) 685-1450 |
NPI Number | 1295802619 |
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Provider Enumeration Date | 11/29/2006 |
Last Update Date | 10/01/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295802619 | NPI | - | NPPES |
5300880 | Medicaid | SD | |
4994699 | Other | SD | WELLMARK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 0304 (South Dakota) | Primary |
Bennett County Hospital And Nursing Home Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Major Allen St, Martin, SD 57551 Phone: 605-685-1660 | |
Bennett County Hospital And Nursing Home Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 102 Major Allen St, Martin, SD 57551 Phone: 605-685-6622 | |