Individual
PHILLIP E MEEHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1301 S. CLIFF AVE, STE 610, SIOUX FALLS, SD 57105-1032
(605) 322-8860
(605) 322-8868
Mailing address
2400 S. MINNESOTA AVE, STE 100, SIOUX FALLS, SD 57105-3762
(605) 322-7510
(605) 322-6475
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0571
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0127834
MEDICA
SD
05
—
10025568900
—
NE
01
—
1609809094
ARAZ/ AMERICA'S PPO
SD
05
—
1821021304
—
IA
01
—
248340
MIDLANDS CHOICE
SD
01
—
46L92ME
CC SYSTEMS/ BLUE PLUS
MN
01
—
4992676
BLUE CROSS
SD
01
—
57105AT04
WPS TRICARE
SD
05
—
6827152
—
SD
01
—
9238709
DAKOTACARE
SD
01
—
C83141041559
PREFERRED ONE
SD
Enumeration date
07/08/2006
Last updated
12/18/2013
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