Individual
MARK JAMES JAMESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
1417 S CLIFF AVE STE 300, SIOUX FALLS, SD 57105-1062
(605) 504-3000
(605) 504-3001
Mailing address
1417 S CLIFF AVE STE 300, SIOUX FALLS, SD 57105-1062
(605) 504-3000
(605) 504-3001
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
0101241309
VA
207Y00000X
Otolaryngology Physician
Primary
13192
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0487819
—
IA
05
—
1073564993
—
VA
01
—
20003
WELLMARK BCBS
IA
01
—
P00347197
MEDICARE RAILROAD
IA
Enumeration date
05/15/2006
Last updated
02/01/2022
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