Organization
AVERA MCKENNAN
Active
Other names
Avera Medical Group McGreevy Brandon
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE N NORTON (SR VICE PRESIDENT OF FINANCE)
(605) 322-7818
Entity
Organization
Contact information
Practice address
1101 E HOLLY BLVD, BRANDON, SD 57005-1426
(605) 582-3853
(605) 582-3855
Mailing address
PO BOX 86430, SIOUX FALLS, SD 57118-6430
(605) 322-4900
(605) 322-4910
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0716829
—
IA
Enumeration date
11/29/2006
Last updated
05/10/2012
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