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Organization

AVERA MCKENNAN

Active
Other names
Avera Lee Mabee OB/GYN
Organization subpart
No

Provider details

NPI number
Authorized official
JULIE NORTON (CFO/SVP)
(605) 322-7818
Entity
Organization

Contact information

Practice address
1910 W 69TH ST, SUITE 100, SIOUX FALLS, SD 57108-5612
(605) 322-5260
(605) 322-5265
Mailing address
PO BOX 84632, SIOUX FALLS, SD 57118-4632
(605) 322-5260
(605) 322-5265

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2481
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0009398
WALLMARK
01
22232
SIOUX VALLEY HEALTH PLAN
01
228834
MIDLANDS CHOICE
05
6200390
SD
Enumeration date
12/05/2005
Last updated
05/31/2017
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