Organization
AVERA MCKENNAN
Active
Other names
Avera Medical Group Brain and Spine Institute
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD PLACE (CEO/PRESIDENT)
(605) 322-8000
Entity
Organization
Contact information
Practice address
1301 S. CLIFF AVE., SIOUX FALLS, SD 57105-1032
(605) 322-8860
(605) 322-8868
Mailing address
PO BOX 86370, SIOUX FALLS, SD 57118-6370
(605) 322-7510
(605) 322-6475
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167009
HEALTHPARTNERS
SD
01
—
46L90AV
BLUE PLUS
MN
01
—
4992512
BLUE CROSS/SOUTH DAKOTA
SD
01
—
9251037
DAKOTACARE
SD
Enumeration date
09/19/2007
Last updated
10/28/2024
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