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Individual

RANDY OPPOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
6215 SOUTH CLIFF AVENUE, SIOUX FALLS, SD 57108-8589
(605) 322-4130
(605) 322-4131
Mailing address
PO BOX 86430, SIOUX FALLS, SD 57118-6430
(605) 322-4900
(605) 322-4910

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0620
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0620
PA LICENSE
SD
Enumeration date
06/10/2006
Last updated
05/09/2016
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