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Organization

AVERA ST. LUKE'S

Active
Other names
Avera Medical Group Ipswich
Organization subpart
No

Provider details

NPI number
Authorized official
TODD FORKEL (PRESIDENT AND CEO)
(605) 622-5125
Entity
Organization

Contact information

Practice address
501 BLOEMENDAAL DRIVE, IPSWICH, SD 57451
(605) 622-2857
(605) 622-2859
Mailing address
PO BOX 1460, ABERDEEN, SD 57402-1460
(605) 622-2857
(605) 622-2859

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
06/22/2012
Last updated
06/22/2012
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