Organization
AVERA MCKENNAN
Active
Other names
Avera Medical Group Addiction Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID WILLIAM FLICEK (PRESIDENT/CEO)
(605) 322-7915
Entity
Organization
Contact information
Practice address
4400 W 69TH ST STE 3100, SIOUX FALLS, SD 57108-8170
(605) 504-3522
(605) 322-4345
Mailing address
PO BOX 86370, SIOUX FALLS, SD 57118-6370
(605) 322-6408
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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