| Selby Medical Clinic | |
|
4401 Main St Selby SD 57472-2010 | |
| (605) 649-9999 | |
| Not Available |
| Full Name | Selby Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 4401 Main St, Selby, South Dakota |
| Authorized Official Name and Position | John Joseph Ayoub (CEO) |
| Authorized Official Contact | 6058458105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Selby Medical Clinic Po Box 580 Mobridge SD 57601-0580 Ph: (605) 649-9999 | Selby Medical Clinic 4401 Main St Selby SD 57472-2010 Ph: (605) 649-9999 |
| NPI Number | 1093335333 |
|---|---|
| Provider Enumeration Date | 04/16/2020 |
| Last Update Date | 01/28/2021 |
| Medicare PECOS PAC ID | 6507776135 |
|---|---|
| Medicare Enrollment ID | O20200616002751 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093335333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Avera Medical Group Selby Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4401 Main St, Selby, SD 57472 Phone: 605-649-9999 Fax: 605-946-9987 |