Individual
JACK C GASPARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1305 W 18TH ST, SIOUX FALLS, SD 57105-0401
(605) 338-5488
Mailing address
PO BOX 1321, SIOUX FALLS, SD 57101-1321
(605) 338-5488
(605) 373-9971
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4481
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005667
BCBS
SD
05
—
0509786
—
IA
05
—
1632895-01
—
TX
05
—
209336106
—
MO
01
—
50P05GA
BCBS
MN
05
—
551713300
—
MN
05
—
5707160
—
SD
Enumeration date
02/27/2006
Last updated
04/17/2017
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