Individual
KELLY J SEIFERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1310 W 22ND ST, SIOUX FALLS, SD 57105-1501
(605) 328-8200
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
94-400148
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054383
BCBS INDIVIDUAL
KS
05
—
100346260A
—
KS
05
—
100371500A
—
KS
01
—
110440
BCBS GROUP
KS
05
—
463272
—
KS
01
—
481206903
TAX ID
KS
01
—
48120690366201A003
CHAMPUS
KS
01
—
970008179
MEDICARE RAILROAD
KS
Enumeration date
10/11/2006
Last updated
11/15/2021
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