# AVERA ST. LUKE'S

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Aberdeen Internal Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477750289
- **Authorized official:** RON L JACOBSON (PRESIDENT & CEO)
- **Authorized official phone:** (605) 622-5125

## Contact information

- **Practice address:** 201 S LLOYD ST, SUITE W270, ABERDEEN, SD 57401-4552
- **Practice address phone:** (605) 225-4070
- **Practice address fax:** (605) 725-2416
- **Mailing address:** PO BOX 1460, ABERDEEN, SD 57402-1460
- **Mailing address phone:** (605) 225-4070
- **Mailing address fax:** (605) 725-2416

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 10525 | SD | Yes |

## Other

- **Enumeration date:** 06/27/2007
- **Last updated:** 06/30/2011