Tetzlaff, Thomas R

Tetzlaff, Thomas R is an individual health care provider with primary practice located at 800 East 21St Street , Sioux Falls SD 57105-1016. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is his primary health care specialty. Tetzlaff, Thomas R can be contacted via phone (605) 322-8000.

Contact Information

Primary practice address
800 East 21St Street Sioux Falls SD 57105-1016
Phone: (605) 322-8000
Fax: (702) 853-8505
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 3374 Nevada
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4674 South Dakota
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 4674 South Dakota

Profile Details

NPI number 1790733582
LBN Legal business name Tetzlaff, Thomas R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Nov 13th, 2008 - about 16 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 1790733582 NPPES
Nevada MEDICAID 002016073
Nevada MEDICAID 1790733582
Nevada MEDICAID 6701390

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