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Individual

DR. DAVID R. LONBAKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 224-7070
(605) 224-2514
Mailing address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 224-7070
(605) 224-2514

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
131
SD
213E00000X
Podiatrist
Primary
SD131
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6800190
SD
Enumeration date
02/24/2006
Last updated
04/04/2012
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