Organization
CREEKSIDE MEDICAL CLINIC, PROF. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANCY E BABBITT M.D. (OWNER/PHYSICIAN)
(605) 341-1208
Entity
Organization
Contact information
Practice address
2620 JACKSON BLVD, SUITE C, RAPID CITY, SD 57702-1502
(605) 341-1208
Mailing address
2620 JACKSON BLVD, SUITE C, RAPID CITY, SD 57702-1502
(605) 341-1208
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4583
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5610718
—
SD
Enumeration date
08/03/2010
Last updated
08/03/2010
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