Organization
MIDLANDS CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH VOLLSTEDT M.D. (PRESIDENT)
(605) 217-5500
Entity
Organization
Contact information
Practice address
705 N SIOUX POINT RD, SUITE 100, DAKOTA DUNES, SD 57049-5091
(605) 217-5500
(605) 217-5515
Mailing address
705 N SIOUX POINT RD, SUITE 100, DAKOTA DUNES, SD 57049-5091
(605) 217-5500
(605) 217-5515
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0181313
—
IA
01
—
DC3945
MEDICARE RR
SD
Enumeration date
10/03/2006
Last updated
07/07/2020
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