Organization
AVERA ST. LUKE'S
Active
Other names
Avera St. Luke's FastCare Shopko
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RON L JACOBSON (PRESIDENT & CEO)
(605) 622-5125
Entity
Organization
Contact information
Practice address
500 N HIGHWAY 281, ABERDEEN, SD 57401-1821
(605) 622-2856
(605) 622-5963
Mailing address
PO BOX 1460, ABERDEEN, SD 57402-1460
(605) 622-2856
(605) 622-5963
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10525
SD
Other
Enumeration date
05/26/2009
Last updated
06/29/2011
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