# AVERA MCKENNAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Medical Group Addiction Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013668698
- **Authorized official:** DAVID WILLIAM FLICEK (PRESIDENT/CEO)
- **Authorized official phone:** (605) 322-7915

## Contact information

- **Practice address:** 4400 W 69TH ST STE 3100, SIOUX FALLS, SD 57108-8170
- **Practice address phone:** (605) 504-3522
- **Practice address fax:** (605) 322-4345
- **Mailing address:** PO BOX 86370, SIOUX FALLS, SD 57118-6370
- **Mailing address phone:** (605) 322-6408

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/14/2022
- **Last updated:** 01/14/2022