AVERA ST. LUKE'S NPI 1639373756

NPI Information

NPI: 1639373756
Provider Name: AVERA ST. LUKE'S

Doing Business As: MOBRIDGE FAMILY PRACTICE CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1400 10TH AVE W
MOBRIDGE, SD
ZIP 57601
Phone: (605) 845-7292
Get Directions

AVERA ST. LUKE'S is a family medicine in Mobridge, SD. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. AVERA ST. LUKE'S NPI is 1639373756. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Mobridge Family Practice Clinic.

The provider's business location address is:

1400 10TH AVE W
MOBRIDGE, SD
ZIP 57601-246
Phone: (605) 845-7292
Fax: (605) 845-7812

The provider's authorized official is Ron L Jacobson .
The authorized official title is Ceo and has the following contact phone number (605) 622-5000.

The enumeration date for this NPI number is 6/13/2007 and was last updated on 1/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		10525	SOUTH DAKOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	S6153	MEDICARE PIN	SOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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