Organization
AVERA ST LUKES
Active
Other names
Avera St Lukes Physician Specialist Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
RON JACOBSON (PRESIDENT)
(605) 622-5502
Entity
Organization
Contact information
Practice address
1400 10TH AVE W, MOBRIDGE, SD 57601-1246
(605) 845-7292
(605) 845-7812
Mailing address
1400 10TH AVE W, MOBRIDGE, SD 57601-1246
(605) 845-7292
(605) 845-7812
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
246R00000X
Pathology Technician
Primary
—
—
Other
Enumeration date
07/13/2006
Last updated
09/11/2025
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