Organization
ADULT AND ADOLESCENT INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE J BRANDT (CFO)
(605) 335-1952
Entity
Organization
Contact information
Practice address
2200 N KIMBALL ST STE 300, MITCHELL, SD 57301-1199
(605) 995-0857
(605) 995-0864
Mailing address
PO BOX 5126, SIOUX FALLS, SD 57117-5126
(605) 335-1952
(605) 373-9971
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008099
BCBS
SD
01
—
DF5256
RAILROAD MEDICARE
SD
Enumeration date
05/23/2006
Last updated
02/19/2013
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