Organization
AVERA MCKENNAN
Active
Other names
Avera University Psychiatry Associates-Marshall
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE N NORTON (SENIOR VP OF FINANCE)
(605) 322-6375
Entity
Organization
Contact information
Practice address
1104 E COLLEGE DR, STE. B, MARSHALL, MN 56258-4270
(507) 337-2923
(507) 337-2926
Mailing address
PO BOX 86370, SIOUX FALLS, SD 57118-6370
(605) 322-7510
(605) 322-6475
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81G87AV
BLUE CROSS
MN
01
—
86467
HEALTHPARTNERS
SD
05
—
996458400
—
MN
01
—
CG9797
RR MEDICARE
SD
Enumeration date
01/07/2008
Last updated
03/31/2010
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