Individual
DAVID L KLOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7350
(605) 755-1000
Mailing address
353 FAIRMONT BLVD, ATTEN CHRISTIE MSS, RAPID CITY, SD 57701-7350
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36592
MN
207R00000X
Internal Medicine Physician
Primary
8690
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110002340
RAILROAD MEDICARE
MN
05
—
35102200
—
WI
05
—
402714100
—
MN
05
—
ENROLLED
—
IA
Enumeration date
01/23/2006
Last updated
05/13/2014
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