# AVERA MCKENNAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Breast Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467695767
- **Authorized official:** DAVID FLICEK (PRESIDENT/CEO)
- **Authorized official phone:** (605) 322-7916

## Contact information

- **Practice address:** 1000 E 23RD ST, SUITE 330, SIOUX FALLS, SD 57105-2113
- **Practice address phone:** (605) 322-7465
- **Practice address fax:** (605) 322-1789
- **Mailing address:** PO BOX 5045, ATTN: PT FINAN SERVICES, SIOUX FALLS, SD 57117-5045
- **Mailing address phone:** (605) 322-6400
- **Mailing address fax:** (605) 322-6499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 10563 | SD | Yes |

## Other

- **Enumeration date:** 04/16/2009
- **Last updated:** 01/08/2021