Individual
ROY L MORTINSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 S PLUM ST, VERMILLION, SD 57069-3346
(605) 624-9111
(605) 624-6636
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-4539
(605) 328-4531
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5066
SD
207Q00000X
Family Medicine Physician
5066
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5611220
—
SD
Enumeration date
06/30/2005
Last updated
03/25/2022
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