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Organization
AVERA ST LUKES
Active
Organization
AVERA ST LUKES
Active
Other names
ABERDEEN PULMONOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
RON JACOBSON (PRESIDENT)
(605) 622-5125
Entity
Organization
Contact information
Practice address
201 S LLOYD ST STE W240, ABERDEEN, SD 57401-4530
(605) 622-2530
(605) 622-2531
Mailing address
201 S LLOYD ST STE W240, ABERDEEN, SD 57401-4530
(605) 622-2530
(605) 622-2531
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
NULL
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Enumeration date
09/11/2006
Last updated
08/22/2020
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