# AVERA MCKENNAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Medical Group Eye Care, Avera Medical Group Ophthalmology Sioux Falls
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417246901
- **Authorized official:** DAVID FLICEK (SENIOR VP OF FINANCE)
- **Authorized official phone:** (605) 322-7915

## Contact information

- **Practice address:** 911 E 20TH ST STE 101, SIOUX FALLS, SD 57105-1043
- **Practice address phone:** (605) 322-3790
- **Practice address fax:** (605) 322-3791
- **Mailing address:** PO BOX 86370, SIOUX FALLS, SD 57118-6370
- **Mailing address phone:** (605) 322-7510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/05/2011
- **Last updated:** 11/25/2019