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Organization
FAMILY MEDICINE CLINIC OF YANKTON PROFESSIONAL LLC
Active
Organization
FAMILY MEDICINE CLINIC OF YANKTON PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY R RAFFERTY MD (SOLE MEMBER)
(605) 665-0555
Entity
Organization
Contact information
Practice address
1000 WEST 4TH STREET, SUITE 15 FAMILY MEDICINE CLINIC OF YANKTON PROF LLC, YANKTON, SD 57078
(605) 665-0555
(605) 665-4498
Mailing address
1000 WEST 4TH STREET, SUITE 15 FAMILY MEDICINE CLINIC OF YANKTON PROF LLC, YANKTON, SD 57078
(605) 665-0555
(605) 665-4498
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4270
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5610162
—
SD
Enumeration date
09/27/2006
Last updated
04/05/2013
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