Individual
ROY G BURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3015 3RD AVE SE, STE 100, ABERDEEN, SD 57401-5418
(605) 725-1700
(605) 725-1708
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1376
SD
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
1376
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376
DAKOTACARE
SD
05
—
6600040
—
SD
Enumeration date
11/28/2006
Last updated
03/29/2012
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