Avera St Lukes Physician Specialist Clinic

LBN: Avera St Lukes
Avera St Lukes Physician Specialist Clinic is an health care organization with primary practice located at 1400 10Th Ave W , Mobridge SD 57601-1246. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Technologists, Technicians & Other Technical Service Providers / Technician, Pathology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is the primary health care specialty. Avera St Lukes can be contacted via phone (605) 845-7292, or through Jacobson, Ron via phone (605) 622-5502.

Contact Information

Primary practice address
1400 10Th Ave W Mobridge SD 57601-1246
Phone: (605) 845-7292
Fax: (605) 845-7812
Website:
Map and Directions
Authorized official contact:
Name: Jacobson, Ron
Phone: (605) 622-5502

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X
Technologists, Technicians & Other Technical Service Providers / Technician, Pathology 246R00000X

Profile Details

NPI number 1174548937
LBN Legal business name Avera St Lukes
DBA Doing business as Avera St Lukes Physician Specialist Clinic
Authorized official Jacobson, Ron
Entity Organization
Organization subpart 1 No
Enumeration date Jul 13th, 2006
Last updated Aug 22nd, 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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