Knudson, Jason

Knudson, Jason is an individual health care provider with primary practice located at 1420 N 10Th St , Spearfish SD 57783. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Knudson, Jason can be contacted via phone (605) 642-8414.

Contact Information

Primary practice address
1420 N 10Th St Spearfish SD 57783
Phone: (605) 642-8414
Fax: (605) 642-8618
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5441 South Dakota

Profile Details

NPI number 1265405864
LBN Legal business name Knudson, Jason
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Feb 6th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265405864 NPPES
South Dakota MEDICAID 5611080

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