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Organization

AVERA MCKENNAN

Active
Parent organization
AVERA MCKENNAN
Other names
AMG Occupational Medicine Sioux Falls
Organization subpart
Yes

Provider details

NPI number
Legal business name
AVERA MCKENNAN
Authorized official
JULIE NORTON (SR VP FINANCE)
(605) 322-7818
Entity
Organization

Contact information

Practice address
4928 N CLIFF AVE, SIOUX FALLS, SD 57104-0563
(605) 332-5100
(605) 322-5101
Mailing address
4928 N CLIFF AVE, SIOUX FALLS, SD 57104-0563
(605) 332-5100
(605) 322-5101

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
5335
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33732
IA MEDICAL LICENSE
IA
01
5335
SD MEDICAL LICENSE
SD
Enumeration date
03/29/2007
Last updated
06/03/2013
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