Organization
YANKTON EAR NOSE AND THROAT PC
Active
Organization
YANKTON EAR NOSE AND THROAT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY J LIUDAHL MD (PROVIDER AND OWNER)
(605) 665-6820
Entity
Organization
Contact information
Practice address
409 SUMMIT ST STE 2800, YANKTON, SD 57078-3735
(605) 665-6820
(605) 665-6821
Mailing address
409 SUMMIT ST STE 2800, YANKTON, SD 57078-3735
(605) 665-6820
(605) 665-6821
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0389
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008554
BLUE CROSS BLUE SHIELD
SD
01
—
CK4038
RAILROAD MEDICARE
SD
Enumeration date
08/20/2006
Last updated
02/22/2013
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