Organization
AVERA ST. LUKE'S
Active
Other names
Aberdeen Plastic Surgery Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD FORKEL (PRESIDENT & CEO)
(605) 622-5125
Entity
Organization
Contact information
Practice address
201 S LLOYD ST, SUITE W230, ABERDEEN, SD 57401-4552
(605) 725-5030
(605) 725-5028
Mailing address
PO BOX 1460, ABERDEEN, SD 57402-1460
(605) 725-5030
(605) 725-5028
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
10525
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14893
—
ND
Enumeration date
08/12/2008
Last updated
08/27/2013
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