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Organization
SANFORD CLINIC NORTH
Active
Organization
SANFORD CLINIC NORTH
Active
Other names
Sanford Health Broadway Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TONY LEE MORRISON (VP, REVENUE CYCLE)
(605) 328-8380
Entity
Organization
Contact information
Practice address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-8311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
379186602
FEDERAL WORKERS COMP
MN
01
—
DS4138
RR MEDICARE
MN
Enumeration date
02/08/2012
Last updated
10/07/2024
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