# AVERA MCKENNAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Medical Group Urogynecology Sioux Falls
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003188269
- **Authorized official:** DAVID FLICEK (CEO/PRESIDENT)
- **Authorized official phone:** (605) 322-8000

## Contact information

- **Practice address:** 6100 S LOUISE AVE STE 1110, SIOUX FALLS, SD 57108-6021
- **Practice address phone:** (605) 504-1570
- **Mailing address:** PO BOX 86370, SIOUX FALLS, SD 57118-6370
- **Mailing address phone:** (605) 322-7510
- **Mailing address fax:** (605) 322-6475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/03/2012
- **Last updated:** 11/01/2019