Organization
MITCHELL DIAGNOSTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY PARR (OFFICE MANAGER)
(605) 996-2031
Entity
Organization
Contact information
Practice address
2250 N KIMBALL ST STE 600, MITCHELL, SD 57301-5335
(605) 996-2031
(605) 996-4496
Mailing address
2250 N KIMBALL ST STE 600, MITCHELL, SD 57301-5335
(605) 996-2031
(605) 996-4496
Taxonomy
Speciality
Code
Description
License number
State
246XC2903X
Vascular Specialist/Technologist Cardiovascular
48461
SD
246XS1301X
Sonography Specialist/Technologist Cardiovascular
48461
SD
247100000X
Radiologic Technologist
42168
SD
2471B0102X
Bone Densitometry Radiologic Technologist
42168
SD
2471N0900X
Nuclear Medicine Technology Radiologic Technologist
42168
SD
291U00000X
Clinical Medical Laboratory
Primary
43D0407438
SD
374700000X
Technician
18136
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
690006160
RAILROAD MEDICARE
SD
Enumeration date
07/05/2006
Last updated
05/29/2008
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