| Sanford Molecular Imaging Clinic | |
|
1205 S Grange Ave Ste 301 Sioux Falls SD 57105-0410 | |
| (605) 328-2170 | |
| (605) 328-2171 |
| Full Name | Sanford Molecular Imaging Clinic |
|---|---|
| Speciality | Nuclear Medicine |
| Location | 1205 S Grange Ave Ste 301, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Tony Lee Morrison (VICE PRESIDENT, REVENUE CYCLE) |
| Authorized Official Contact | 6053288380 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanford Molecular Imaging Clinic Po Box 5074 Sioux Falls SD 57117-5074 Ph: (605) 328-6585 | Sanford Molecular Imaging Clinic 1205 S Grange Ave Ste 301 Sioux Falls SD 57105-0410 Ph: (605) 328-2170 |
| NPI Number | 1679519458 |
|---|---|
| Provider Enumeration Date | 06/21/2006 |
| Last Update Date | 02/28/2023 |
| Certification Date | 02/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679519458 | NPI | - | NPPES |
| 0537886 | Medicaid | IA | |
| 281988100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 207U00000X | Nuclear Medicine | () | Primary |
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