Individual
JASON KNUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1420 N 10TH ST, SPEARFISH, SD 57783
(605) 642-8414
(605) 642-8618
Mailing address
353 FAIRMONT BLVD, ATTEN MEDICAL STAFF SERVICES, RAPID CITY, SD 57701-6000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5441
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5611080
—
SD
Enumeration date
02/13/2006
Last updated
02/06/2013
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