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Individual

WESLEY L SUFFICOOL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
211 FOUNDERS PARK DR STE 2, RAPID CITY, SD 57701-8099
(605) 791-5553
(605) 791-5644
Mailing address
211 FOUNDERS PARK DR STE 2, RAPID CITY, SD 57701-8099
(605) 791-5553
(605) 791-5644

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4023
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00416084
RR MEDICARE
SD
Enumeration date
10/12/2006
Last updated
07/14/2023
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