Organization
DAKOTA PSYCHIATRY CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES J LORD MD (PSYCHIATRIST)
(605) 348-6365
Entity
Organization
Contact information
Practice address
419 QUINCY STREET, RAPID CITY, SD 57701
(605) 348-6365
(605) 348-9408
Mailing address
419 QUINCY STREET, RAPID CITY, SD 57701
(605) 348-6365
(605) 348-9408
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
E2684
TX
2084P0800X
Psychiatry Physician
Primary
SD 2247
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4998327
BCBS
—
05
—
7100080
—
SD
Enumeration date
07/13/2006
Last updated
08/22/2020
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