Organization
SUMMIT ALLERGY ASTHMA ENT PLLC
Active
Organization
SUMMIT ALLERGY ASTHMA ENT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VAUGHAN RICHARD BOWEN MD (OWNER)
(605) 716-0548
Entity
Organization
Contact information
Practice address
4447 S CANYON RD STE 6, RAPID CITY, SD 57702-1889
(605) 716-0548
Mailing address
15381 RIDGEVIEW TRL, PIEDMONT, SD 57769-7227
(605) 716-0548
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124484688
—
NE
05
—
1376520049
—
SD
Enumeration date
04/26/2022
Last updated
04/29/2022
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