Organization
AVERA MCKENNAN
Active
Other names
Avera Medical Group Garretson
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE N. NORTON (SENIOR VICE PRESIDENT FINANCE)
(605) 322-6375
Entity
Organization
Contact information
Practice address
980 4TH STREET, GARRETSON, SD 57030-0250
(605) 594-3431
Mailing address
908 4TH ST., GARRETSON, SD 57030
(605) 594-3431
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3579
SD
207Q00000X
Family Medicine Physician
4884
SD
207Q00000X
Family Medicine Physician
5054
SD
207Q00000X
Family Medicine Physician
5214
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5609088
—
SD
05
—
5610962
—
SD
05
—
5611292
—
SD
05
—
5611473
—
SD
Enumeration date
01/08/2007
Last updated
03/21/2011
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