Individual
DR. SCOTT GREGORY VANKEULEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1305 W 18TH ST, SIOUX FALLS, SD 57105-0401
(605) 333-6688
(605) 333-1578
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
38833
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3339665
—
TN
01
—
4091381
BLUE CROSS
TN
01
—
P00240877
RRGA
TN
Enumeration date
06/02/2006
Last updated
01/20/2009
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