Organization
W.A. BOADE, MD PROF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY ANN JENSEN (OFFICE MANAGER)
(605) 306-6000
Entity
Organization
Contact information
Practice address
4500 N CLIFF AVE, SIOUX FALLS, SD 57104-0553
(605) 306-6000
(605) 221-2141
Mailing address
4500 N CLIFF AVE, SIOUX FALLS, SD 57104-0553
(605) 306-6000
(605) 221-2141
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6600093
—
SD
Enumeration date
06/27/2007
Last updated
08/22/2020
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