Organization
BOWDLE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON KOSIAK (CEO)
(605) 285-6146
Entity
Organization
Contact information
Practice address
8001 WEST 5TH STREET, BOWDLE, SD 57428-0556
(605) 285-6832
(605) 285-6986
Mailing address
P.O. BOX 556, BOWDLE, SD 57428-0556
(605) 285-6146
(605) 285-6410
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0030101
BLUE CROSS
SD
05
—
5800500
—
SD
Enumeration date
12/29/2006
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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