Individual
DR. RODNEY T VIZCARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 945-5202
(605) 945-5094
Mailing address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 945-5202
(605) 945-5094
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
3621
SD
208600000X
Surgery Physician
Primary
SD3621
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7301310
—
SD
05
—
7301312
—
SD
Enumeration date
04/07/2006
Last updated
04/13/2012
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