Organization
SANFORD CLINIC NORTH
Active
Other names
Sanford Health Broadway Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TONY LEE MORRISON (VP, REVENUE CYCLE)
(605) 328-8380
Entity
Organization
Contact information
Practice address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-8311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
379186602
FEDERAL WORKERS COMP
MN
01
—
DS4138
RR MEDICARE
MN
Enumeration date
02/08/2012
Last updated
10/07/2024
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