Organization
AVERA ST. LUKE'S
Active
Other names
Marshall County Medical Clinic Avera
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RON L JACOBSON (PRESIDENT AND CEO)
(605) 622-5125
Entity
Organization
Contact information
Practice address
415 9TH ST, BRITTON, SD 57430-2274
(605) 448-5953
(605) 448-2304
Mailing address
PO BOX N, BRITTON, SD 57430-0626
(605) 448-5953
(605) 448-2304
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13974
—
ND
01
—
9172758
DAKOTACARE
—
Enumeration date
01/03/2007
Last updated
12/07/2011
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