Avera Medical Group Dermatology Sioux Falls

LBN: Avera Mckennan
Avera Medical Group Dermatology Sioux Falls is an health care organization with primary practice located at 6701 S Minnesota Ave , Sioux Falls SD 57108-2591. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Avera Mckennan can be contacted via phone (605) 322-6960, or through Flicek, David via phone (605) 322-8000.

Contact Information

Primary practice address
6701 S Minnesota Ave Sioux Falls SD 57108-2591
Fax: (605) 322-6961
Website:
Authorized official contact:
Name: Flicek, David

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X

Profile Details

NPI number 1346216074
LBN Legal business name Avera Mckennan
DBA Doing business as Avera Medical Group Dermatology Sioux Falls
Authorized official Flicek, David
Entity Organization
Organization subpart 1 No
Enumeration date Feb 23rd, 2006
Last updated Jul 31st, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346216074 NPPES
Minnesota MEDICAID 115182700
Minnesota Other 370624200
Minnesota Other 396S9MI
Minnesota Other 9202239
Minnesota Other 040122003
Minnesota Other 83986
Minnesota MEDICAID 0554733
Minnesota Other 0040219
Minnesota Other 396S9MI

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