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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