Organization
HURON CLINIC FOUNDATION LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEANNE KOPFMANN (CLINIC ADMINISTRATOR)
(605) 352-8691
Entity
Organization
Contact information
Practice address
111 4TH ST SE, HURON, SD 57350-2509
(605) 352-8691
(605) 352-1617
Mailing address
111 4TH ST SE, HURON, SD 57350-2509
(605) 352-8691
(605) 352-8704
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
43D0407501
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001
TRICARE
—
05
—
5585000
—
SD
Enumeration date
08/11/2005
Last updated
01/24/2019
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