Individual
MITCH D. POPPENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
323 SW 10TH ST, MADISON, SD 57042-3200
(605) 256-6551
(605) 256-6469
Mailing address
323 SW 10TH ST, MADISON, SD 57042-3200
(605) 256-6551
(605) 256-6469
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0522
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6824594
—
SD
Enumeration date
12/23/2005
Last updated
02/21/2017
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