# AVERA MCKENNAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Medical Group Comprehensive Weight Management
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457096133
- **Authorized official:** DAVID WILLIAM FLICEK (PRESIDENT/CEO)
- **Authorized official phone:** (605) 322-7915

## Contact information

- **Practice address:** 911 E 20TH ST STE 200, SIOUX FALLS, SD 57105-1044
- **Practice address phone:** (605) 504-0400
- **Practice address fax:** (605) 504-0401
- **Mailing address:** PO BOX 86370, SIOUX FALLS, SD 57118-6370

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/28/2022
- **Last updated:** 04/28/2022