Sietstra, Philip G

Sietstra, Philip G is an individual health care provider with primary practice located at 5116 S Western Ave , Sioux Falls SD 57108-2677. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Sietstra, Philip G can be contacted via phone (605) 338-7104.

Contact Information

Primary practice address
5116 S Western Ave Sioux Falls SD 57108-2677
Phone: (605) 338-7104
Fax: (605) 575-3880
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X T143 South Dakota

Profile Details

NPI number 1376544833
LBN Legal business name Sietstra, Philip G
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Sep 2nd, 2011 - about 13 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 1376544833 NPPES
Other 410038933 RR MEDICARE
MEDICAID 9201122 RR MEDICARE
Other 57D35SI RR MEDICARE

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