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SANFORD CLINIC

Physicians Dermatology

Provider NPI: 1023203619

Organization Information:
Organization Name:  SANFORD CLINIC
Organization is not Subpart
Authorized Official:  STEVE  GOETSCH  CFO  605-328-6940

Practice Location:
5019 S WESTERN AVE STE 200 SIOUX FALLS, SD 57108-5095 US
Tel: 605-328-9700  Fax: --

Business Mailing Address:
PO BOX 5074  SIOUX FALLS, SD 57117-5074 US
Tel: 605-328-8395  Fax: 605-328-9401

NPI Information:
NPI: 1023203619
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207N00000XPhysicians
Dermatology
N207V00000XPhysicians
Obstetrics & Gynecology
N208200000XPhysicians
Plastic Surgery
N207RC0000XPhysicians
Internal Medicine
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Y207R00000XPhysicians
Internal Medicine

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 207R00000X

Type:

Classification:



Definition:



MEDICAL JOBS SD - Page 1

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