Organization
SANFORD CLINIC
Active
Other names
Sanford Clinic Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE GOETSCH (CFO)
(605) 328-6940
Entity
Organization
Contact information
Practice address
1508 W 22ND ST, STE 101, SIOUX FALLS, SD 57105-1506
(605) 328-3840
(605) 328-3841
Mailing address
1508 W 22ND ST, STE 101, SIOUX FALLS, SD 57105-1506
(605) 328-3840
(605) 328-3841
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
207P00000X
Emergency Medicine Physician
—
—
208600000X
Surgery Physician
Primary
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0537886
—
IA
05
—
620091500
—
MN
Enumeration date
07/07/2006
Last updated
11/27/2023
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