Liudahl, Jeffrey J

Liudahl, Jeffrey J is an individual health care provider with primary practice located at 100 Mac Lane Avera Medical Group Pierre, Pierre SD 57501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Liudahl, Jeffrey J can be contacted via phone (605) 945-5202.

Contact Information

Primary practice address
100 Mac Lane Avera Medical Group Pierre Pierre SD 57501
Phone: (605) 945-5202
Fax: (605) 945-5294
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 1242 South Dakota

Profile Details

NPI number 1972618924
LBN Legal business name Liudahl, Jeffrey J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2006
Last updated Sep 4th, 2012 - about 14 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 1972618924 NPPES
South Dakota MEDICAID 6520325
South Dakota MEDICAID 6520324

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