Individual
DR. CLARK C DUCHENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7220 MOUNT RUSHMORE RD, RAPID CITY, SD 57702-8754
(604) 341-1414
(605) 341-7062
Mailing address
PO BOX 6850, RAPID CITY, SD 57709-6850
(604) 341-1414
(605) 341-7062
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5361
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1254560001
CIGNA MEDICARE
SD
05
—
6402220
—
SD
01
—
P00142152
MEDICARE RAILROAD PTAN
—
Enumeration date
01/19/2006
Last updated
07/26/2024
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