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NPI Code Detail

MEDICARE: DR. LINDA JO FROMM M.D.

MEDICARE: DR. LINDA JO FROMM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician24277NE
2207N00000XDermatology Physician8292SD

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1S108403OTHERSDMEDICARE PTAN

General Provider Information

NPI Number : 1124210828
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LINDA JO FROMM M.D.
Provider Business Mailing Address
First Line : 4447 S CANYON RD STE 6
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-1889
Country : US
Telephone Number : 605-721-5550
Fax Number : 605-721-5515
Provider Business Practice Location Address
First Line : 4447 S CANYON RD STE 6
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-1889
Country : US
Telephone Number : 605-721-5550
Fax Number : 605-721-5515
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2007
Last Update Date : 03/09/2015

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Directions to “ DR. LINDA JO FROMM M.D.” Practice Location

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