| Avera St. Luke's | |
|
1400 10th Ave W Mobridge SD 57601-1246 | |
| (605) 845-7292 | |
| (605) 845-7812 |
| Full Name | Avera St. Luke's |
|---|---|
| Speciality | Family Medicine |
| Location | 1400 10th Ave W, Mobridge, South Dakota |
| Authorized Official Name and Position | Ron L Jacobson (CEO) |
| Authorized Official Contact | 6056225000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera St. Luke's Po Box 710 Mobridge SD 57601-0710 Ph: (605) 845-7292 | Avera St. Luke's 1400 10th Ave W Mobridge SD 57601-1246 Ph: (605) 845-7292 |
| NPI Number | 1639373756 |
|---|---|
| Provider Enumeration Date | 06/13/2007 |
| Last Update Date | 01/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639373756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 10525 (South Dakota) | Primary |
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